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New India Health Insurance Claim Settlement
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A reputable general insurance provider in the public sector, New India Assurance offers its clients a prompt and efficient claim settlement procedure. You can opt for two types of claim settlement processes provided by the New India Assurance; the cashless claim settlement, and the reimbursement claim settlement. The company comes with a high New India Assurance health insurance claim settlement ratio to provide you with easy and less time-consuming transactions.
The Claim Process for Cashless Treatment for New India Assurance Health Insurance Claim Settlement
With the health insurance from New India Assurance comes the benefits of the claim for cashless treatment. You will have access to impeccable medical attention from the network of hospitals partnered with the company. The process of the claim is fairly easy and time efficient at a time of urgency, with the consistent New India Assurance health insurance settlement ratio. The cashless treatment will provide you with the benefit of not having to pay any cost regarding the medical services throughout the whole procedure. New India Assurance is immediately required to reimburse the medical expenses acknowledged by the health insurance policy you are covered for.
The submission of a cashless New India Assurance health insurance claim settlement consists of the following steps:
There are two variations of cashless claim settlement under New India Assurance, planned and emergency. The only difference between the time procedure is the notice period to the company.
All you need to do to process the cashless claim is as follows:
- For the New India Assurance health insurance claim settlement, you will have to find a network hospital under the company, either through the online locator from their website or by contacting their customer care number.
- Admit into the hospital and show the health card provided to you by New India Assurance.
- The hospital will complete the verification of your identity and get in contact with the company or the TPA for a pre-authorization.
- Your claim will be processed through the administration and will be accepted or declined on the basis of your coverage.
- If the claim gets approved, New India Assurance will pay the due bills directly to the hospital.
- And if in any case the claim gets denied, you will have to pay the amount from your pocket, and later you can file for a reimbursement claim.
The Cashless Claim Procedure After Admission
After the initial claim process to the hospital, the TPA will send your pre-authorization request and any pertinent medical information to the New India Assurance health insurance. Your medical operations may start after the company gives the initial go-ahead following the examination of your claim request. The required documentation by the New India Assurance and the network hospital must be sent to the hospital's TPA, who may review it and request your insurance company's permission if a modification to the allowed cashless amount is required, while the person is in the facility. Following that the hospital's TPA will email a correct billing and release certificate to the company on the day of discharge. After a thorough review of your claim application, the insurance company or its TPA (third-party administrator) gives an expanded authorisation for the whole bill amount. Some non-payable expenses cannot, by law, be covered by the insurance plan once final permission has been granted. In that case, you will be charged by the hospital for them.
List of Documents Required for New India Assurance Health Cashless Claim
The basic documentation needed for the cashless claim is as follows
- The health card is insured by New India Assurance for cashless hospitalisation.
- The proof of identity and age for the hospital’s verification process.
- A prescription with a doctor’s order to get admitted to a hospital.
- All the required medical treatment and tests should be done prior to the hospitalization.
Any other documents required after this will be provided by the hospital to complete the cashless claim smoothly.
How to Check New India Assurance Health Insurance Policy Claim Status?
The New India Assurance health insurance claim settlement ratio is impeccably high but as a client under the company, you may check your claim status through the company-provided portal, which will give you peace of mind regarding the progress of your insurance claim. Keep in mind that there are a lot of factors taken into account while processing a claim.
New India Assurance health insurance claim settlement tracking process for online and offline are as follows:
- The Online Process for New India Assurance Health Insurance Claim Settlement:
To track the claim status of your New India Assurance health insurance plan online, you can do that in 2 ways:
- You can simply log into the website with your customer details:
And then check the status of your claim, or
- Log in to the online portal of your TPA (third-party administrator) and then check the status of your claim with the claim registration number.
- You can simply log into the website with your customer details:
- The Offline Process for New India Assurance Health Insurance Claim Settlement:
To go through the offline process of checking the New India health insurance claim settlement is easy and simple. All you need to do is contact the administration desk through the contact us option on the left side corner of their website. You can contact them through the toll-free number 1800-209-1415, or email your concerns regarding the claim status through the official email provided to you by New India Assurance email@example.com.
You can also process the claim directly from the branch in your locality, which you can locate from the official branch locator provided on the website. Once you get in touch with the branch, the officer in charge of claim settlement may ask for pieces of information such as insurance ID number, intimation number etc. to give you a more detailed status of your claim.
The Claim Process for Reimbursement Treatment for New India Assurance Health Insurance Claim Settlement
A reimbursement claim from New India Assurance health insurance claim settlement would come in handy if for any unforeseen reason you weren't able to access a network hospital for a cashless claim. Although you will have to pay the amount for the treatment and other care received from the admitted hospital once your treatment is completed and your reimbursement claim is approved, the amount insured under your coverage will be paid back to you. The claim must contain all the required documents like hospitalisation bills, medical expenses records, and other related papers to the treatment you received. The following steps will help you with the procedure of a reimbursement claim:
- Try to let the New India Assurance know about the hospitalisation as soon as possible.
- Mention your policy number and details required with it beforehand.
- Make the required payment for the care received at the hospital.
- Go to the New India Assurance health insurance claim settlement website to download the reimbursement claim form.
- Don’t forget to send all the required documents to process the claim to the insurer’s office like medical records, hospital bills, identity proof, and so on.
List of Documents Required for New India Assurance Health Reimbursement Claim
The following details must be provided at the time a claim is made for the New India Assurance health claim settlement ratio:
- Receipt, bill, and hospital discharge certificate or card
- Summary of the care provided to you
- Bill and receipt from the attending physician, consultant, specialist, or anesthetist, as well as a certificate of diagnosis.
- Receipts for payment from the hospital(s), pharmacist(s), and valid prescriptions.
- Such pathological examinations are recommended by a doctor or surgeon.
- Reports of the pathological tests, the pathologist's receipt, and the attending physician's note.
- A doctor's certificate detailing the procedure's nature, together with the doctor's invoice and receipt.
- A post-mortem report, attached to the prescription if required.
- A properly filled out claim form, with the required documents attached to it.
- A photo ID for verification
- The attending Physician’s finding and the original note
- A blank check with your identity, or your bank details
New India Assurance may ask for additional documentation during the registration or claim processing period to verify and approach your New India Assurance health claim ratio.
Incurred Claim Ratio (ICR) of New India Assurance Health Insurance
The ratio of claims paid out by the company to the total premiums actually collected during that time is known as the Incurred Claim Ratio (ICR). It is a reliable method for letting you know how much you can trust a specific health insurance provider. It displays the speed at which claims are processed and the financial efficiency of a health insurance provider. The Insurance Regulatory and Development Authority of India (IRDAI) announces the annual report which informs us about the ICR figures. For the fiscal year 2020-21, New India Assurance's incurred claim ratio is 92.79%.
New India Assurance Health Insurance Claim Settlement Ratio (CSR)
The percentage of claims resolved by the company to all claims received during a financial year is known as the claim settlement ratio of New India Assurance health insurance. It is determined by dividing the entire amount of claims submitted by the overall number of claims that were successfully settled. The claim settlement ratio for New India Assurance for the fiscal year 2020–2021 was 4.45% for claims settled in more than three months and 91.99% for claims completed in less than three months.
New India Health Insurance Claim Settlement FAQs
1. How many different methods does New India Assurance provide claim settlement?
You have the option of using the cashless and reimbursed methods provided by the New India health insurance claim settlement ratio.
2. Can my claim request to New India Assurance be denied in any circumstances?
Yes. If the terms and circumstances of the policy you are insured under and the foundation of your claims don't line up, your request for a claim may be approved or refused.
3. How can I get in contact with the New India Assurance authorities regarding my claim status?
You can use the official website of New India Assurance and use the contact us tab to call on the toll-free 1800-209-1415 number provided to you or email the company through firstname.lastname@example.org for the New India Assurance health insurance claim ratio. The company also has a section to fill in a short form with your name and phone number and the comment regarding your queries, for even easier access to the company.
4. What replacement obligations are there if the claimant misplaces the original New India Assurance policy document?
The policyholder must provide the indemnity bond for lack of policy paper, which must be printed on 200-rupee stamp paper and properly notarized if they have lost their original New India Assurance policy bond.
5. How many network hospitals do I have access to for cashless claims under New India Assurance?
New India Assurance gives you access to approx 3000+ network hospitals under all their coverages. Admitting into one of these hospitals while having a New India Assurance health insurance automatically gives you access to cashless claims.
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