• Religare Health Insurance Claims Procedure

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    Cashless Treatment

    Customer Service

    Medical Coverage

    Claim Experience

    Responsiveness

    Health insurance policies are often as good as their claims are, because the financial aspect of one’s illness and ailment often bears down on a family and the policyholder after the treatment is done with. Claims considering Religare Health Insurance have an easy process that is done online and is completely hassle-free. With nearly 4900 hospitals in its expansive list of healthcare facilities, Religare Heath Insurance also offers an easy process for claims disbursement.

    Incurred Claim Ratio for Religare Health Insurance:

    Though the claim ratio is a highly touted measure of how effective and reliable an insurer is, it is not the only yardstick through which health insurers should be chosen. Irrespective of that, a good incurred claim ratio indicates the speed of the overall process and the efficiency through which an insurer operates. The incurred claim ratio for Religare Health Insurance is shown in the table below –

    For 2015-16:

    Net Earned Premium (in lakhs INR) Net Claims Paid (in lakhs INR) Incurred Claims Ratio (Percentage)
    28773 16472 57.25

    For 2014-15:

    Net Earned Premium (in lakhs INR) Net Claims Paid (in lakhs INR) Incurred Claims Ratio (Percentage)
    15,372 9.397 61.13

    Generally a value from 50% to 90% is a good figure concerning ICR (Incurred Claim Ratios). That indicates Religare actually has built up a good pool of resources from where it can meet the claims that are being generated. It will not be taxing the financials of Religare in any condition.

    Claim Scenarios:

    Claim scenarios normally come up in two forms, either in cashless treatment or in case of reimbursement of expenditure that happens during a treatment. Let’s take a look at how the situations would be in each scenario pertaining to health insurance.

    Cashless Treatment:

    This kind of treatment can be availed across the network of hospitals that have tie-ups with Religare Health. In such cases, one doesn’t need to pay for the treatment as the bills generated are sent across to Religare Health itself.

    Procedure to File a Claim (Planned/Emergency Hospitalisation):

    1. The provided cashless treatment card should be carried on person, or the policy number and member ID should be provided at the network hospital
    2. One should call and inform Religare at the number 1800-200-4488 within 24 hours of admission in case of an emergency hospitalisation
    3. One should either intimate Religare on 1800-200-4488 or write to the customer helpdesk on customerfirst@religarehealthinsurance.com in case of a planned hospitalisation at least 48 hours before
    4. One would need to furnish personal details and policy ID or member ID to the hospital’s insurance desk and fill up the Pre-Authorisation form in the customer’s section
    5. Once the balance details are filled up by the hospital, the Pre-Authorisation form will be faxed to Religare at 1800-200-6677
    6. The Religare in-house medical team will review the case and documents received and intimate the guardian and hospital in case of approval, pending approval or rejection
    7. In case of pending approval cases, Religare will contact the hospital to furnish more details and in cases of rejection, a claim reimbursement process needs to be followed

    Claims Process for Cashless Treatment:

    1. Post the filling up of the pre-authorisation form, the requisite details will be verified by the hospital and the TPA
    2. Upon submission of the pre-authorisation form, all communications will be taken care of by Religare pertaining to the settlement of the bill
    3. If in case some expenses are not covered or are beyond the scope of the policy, the same will be intimated to the patient before or post release from hospitalisation

    Reimbursement of Treatment Expenses:

    In case one has to resort to a hospital that is not in the panel of networked hospitals of Religare or the pre-authorisation form has been rejected, one could file a claim for reimbursement of expenses. The procedure for the same and important points to consider are mentioned below.

    Procedure to File a Claim:

    1. In case of an emergency admission, Religare should be informed of the same within 24 hours of admission on the number 1800-200-4488. If the hospitalisation is planned, the intimation should be done 48 hours in advance on the number 1800-200-4488 or the email address customerfirst@religarehealthinsurance.com
    2. The details required during this procedure will be the following –
      • Policyholder’s name
      • Claimant’s name and customer ID
      • Details of the hospital
      • Details of diagnosis and treatment
      • An approximation of the claim amount
      • Date of admission

    Documents Required:

    The claim form can be downloaded from Religare’s website and along with the filled up form, the following documents need to be provided –

    1. The original copy of the claim form, fully filled and duly signed
    2. Government approved valid photo ID proof
    3. Referral letter from medical practitioner advising hospitalisation
    4. Letter from medical practitioner detailing the list of tests, medications and consultations if any
    5. Original copies of bills, receipts and discharge card from the hospital or the medical practitioner
    6. Original copies of bills or receipts from pharmacies or druggists involved
    7. Original copies of tests and reports done along with payment receipts
    8. Indoor case papers
    9. If applicable, the First Information Report and the Final Police Report
    10. Original copy of the post mortem report, if conducted

    The above list of documents are the bare minimum necessities. Religare might require additional documentation as and when needed.

    The above mentioned list of documents and the claim form needs to be sent via post to the address at –

    Religare Health Insurance Company Limited,

    Claims Department,

    GYS Global, A-3, 4, 5, Sector-125, Noida,

    Uttar Pradesh - 201 301

    Claims Process for Reimbursement Cases:

    Once the filled claim form along with the relevant documents is received by Religare, the claims process is initiated and the following happens –

    1. The in-house medical team of Religare reviews the case and documents received
    2. The case if approved, will cause the reimbursement of funds to be processed and the procedure will be completed within a week and a fortnight. Intimation of the same will be sent to the claimant
    3. In case the request has incomplete information, the same will be intimated to the claimant and requisite details will be requested to ensure claim resolution at the earliest
    4. In case of request rejection, the reason will be mentioned for the same and an intimation sent to the claimant. If there are further documents to strengthen the case, the same will be studied and the claim can be reopened for review.

    This Insurance Company has not partnered with BankBazaar.com. For more details, please visit its website/branch office. The trademarks, logos and other subject matters of intellectual property belong to their respective owners.

    GST rate of 18% applicable for all financial services effective July 1, 2017.

    Disclaimer: Premiums may vary depending upon factors like age, location and prevailing taxes/GST.

    Religare Health Insurance Claims Procedure Reviews

  • Page 1 of 10 1 2 3 4 5
    • Religare Health Insurance
      "Good Policy"
      0.5 3.0/5 "Satisfactory"
      I have my health insured with Religare from last 1.5 years and it is a good insurance policy. I have a coverage value of Rs 3 lakhs which is satisfactory for this insurance policy. I pay a premium of Rs 4800 and i have no claim experience so far from this insurance.
      Was this review helpful? 0
      , hyderabad
      Reviewed on May 28, 2018
    • Religare Health Insurance
      "Good Service"
      0.5 4.0/5 "Great!"
      I've a health insurance from Religare. I pay a premium of 15000 per year and been using the policy for the past 3 years. I never had any claim experience with the policy. The policy renewal was really comfortable even after expiry. Overal it was a good experience.
      Was this review helpful? 0
      , bangalore
      Reviewed on May 15, 2018
    • Religare Health Insurance
      "Good policy to use"
      0.5 5.0/5 "Blown Away!"
      Got the health insurance policy from the RELIGARE HEALTH company around 2months ago. The customer support service is good with the Reliance and they give good service to the customers. This policy covers 4mmebers in my family . This policy has a medical coverage amount of Rs,5,00,000 per head. I have paid Rs,9000 to get this policy and this policy and it has good benefits in it.
      Was this review helpful? 0
      , hyderabad
      Reviewed on May 02, 2018
    • Religare Health Insurance
      "Good Service"
      0.5 4.0/5 "Great!"
      I bought the Religare Health Insurance and I pay a premium of 7200 Per Annually. I dont have any claim experience. My friend had the experience and their Customer support was good. I make the premium payment Online and I've been a customer for the past three years.
      Was this review helpful? 0
      , new delhi
      Reviewed on Apr 29, 2018
    • Religare Health Insurance
      "EXCELLENT"
      0.5 5.0/5 "Blown Away!"
      Religare Health Insurance service is good. The payments are through Ecs. The offers of Religare covers the top hospitals,it was very much helpful for me. The benefits is for the whole family. It was an good experience with Religare Health Insurance service.
      Was this review helpful? 0
      , chennai
      Reviewed on Apr 23, 2018
    • Religare Health Insurance
      "Best policy"
      0.5 5.0/5 "Blown Away!"
      I have my health insured with Religare health 4 months back, i am happy with the coverage value of this insurance policy. A premium of Rs 8000 has to be paid every year for this health insurance. I do not have claim experience so far with this insurance and they cover Rs 5 lakhs for this insurance.
      Was this review helpful? 0
      , ahmedabad
      Reviewed on Apr 20, 2018
    • Religare Health Insurance
      "Good policy"
      0.5 4.0/5 "Great!"
      From RELIGARE Health i have taken the health insurance. They provide cashless facility. There is no claim experience with them. There is health check up available on the insurance policy. Its an individual policy.The customer service and response is good.
      Was this review helpful? 0
      , mumbai
      Reviewed on Apr 20, 2018
    • Religare Health Insurance
      "Excellent Service"
      0.5 5.0/5 "Blown Away!"
      I have an health Insurance with Religare. The benefits is for the whole family. Their offers covers me for the top hospitals. The payments will be regularly deducted through Ecs. As it is an cashless process. I never claimed any service from Religare till now. It is an excellent experience with Religare health insurance service.
      Was this review helpful? 0
      , kolkata
      Reviewed on Apr 04, 2018
    • Religare Health Insurance
      "Average service"
      0.5 3.0/5 "Satisfactory"
      I use the Health insurance policy from the RELIGARE HEALTH for the past 3 years. I pay Rs,7600 to renew the policy every year. This policy covers 2members in the policy and it has the policy medical coverage amount of Rs,600000 and I am satisfied with it.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Mar 31, 2018
    • Religare Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I hold a health insurance with Religare from last 2 years and it is a good policy to use. This policy has to be renewed every year and i pay a premium of Rs 10000 for this insurance. I do not have claim experience so far and i have not taken any cashless treatment. I have a coverage of Rs 5 lakhs and i am satisfied with it.
      Was this review helpful? 0
      , bangalore
      Reviewed on Mar 13, 2018
    • Religare Health Insurance
      "Good policy for Health"
      0.5 5.0/5 "Blown Away!"
      I have taken a health insurance from RELIGARE HEALTH. The premium i have to pay on a yearly basis. I have not yet experienced the insurance policy. They provide reimbursement and the policy would be given to all the family members. And they even proved free health checkup for all the members.
      Was this review helpful? 0
      , jaipur
      Reviewed on Mar 07, 2018
    • Religare Health Insurance
      "Good Service"
      0.5 4.0/5 "Great!"
      I have a health insurance with Religare. The benefits is for the whole family. The offers from Religare health insurance service covers the top hospitals. The payments will deducted through ECS. The customer support is prompt with Religare. It is a good experience with Religare Health insurance service.
      Was this review helpful? 0
      , chandigarh
      Reviewed on Mar 03, 2018
    • Religare Health Insurance
      "Not satisfied"
      0.5 1.0/5 "Really Bad"
      I have taken the health insurance policy with the Religare and the response is not really up to the mark. I would like to say that the customer service could be get improvised with the Religare health insurance company.
      Was this review helpful? 0
      , mumbai
      Reviewed on Mar 03, 2018
    • Religare Health Insurance
      "GOOD SERVICE"
      0.5 4.0/5 "Great!"
      I have taken a health insurance service with Religare,the benefit is for single benefit. The offers cover top hospitals which is good with Religare health insurance service. The payments will be deducted from my credit card,still I have not claimed any service till now from Religare health insurance service.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Mar 02, 2018
    • Religare Health Insurance
      "Better service"
      0.5 4.0/5 "Great!"
      I have taken a Health insurance with Religare,the insurance was taken six months ago,the procedure was too simple as i submitted limited documents.I have no claim experience with them.I need not pay any premium amount as it is taken by the company,the policy was taken for my family members too.
      Was this review helpful? 0
      , bangalore
      Reviewed on Feb 26, 2018
    • Religare Health Insurance
      "Its Good"
      0.5 4.0/5 "Great!"
      RBL gave me the Health insurance from Religare , without my knowledge they have charged me Rs. 3000 of premium, for the tenure of one year. Religare premium was converted into EMI. Religare gave me the medical cover around Rs. 1.5 lakh with cash less treatment facility and they got tie up around 1000 hospital in India.
      Was this review helpful? 0
      , bangalore
      Reviewed on Feb 20, 2018
    • Religare Health Insurance
      "Its Best"
      0.5 5.0/5 "Blown Away!"
      I have corporate insurance from Religare Health, I didn't check the benefits, I believe I got medical cover upto Rs. 3 lakhs for my entire family. I got Religare e card. If in case of any emergency if I admit more than 24 hours I can get the reimbursement. I would suggest to enable daily check on insurance.
      Was this review helpful? 0
      , bangalore
      Reviewed on Feb 16, 2018
    • Religare Health Insurance
      "Bad Experience"
      0.5 1.0/5 "Really Bad"
      This is my first term with Religare Mediclaim plan. 7 months down my Insurance my Brother had an accident, and consequently they didn't cover me up during this time. I had to pay more than Rs.1 Lakhs for the treatment. I applied for it thrice and all the three times it got rejected, they said accidents aren't covered in this Insurance.
      Was this review helpful? 0
      , mumbai
      Reviewed on Feb 16, 2018
    • Religare Health Insurance
      "Good policy to use"
      0.5 4.0/5 "Great!"
      I hold a health insurance with Religare from last 2 years and it is a good insurance policy. This policy has to be renewed every year and i pay a premium of Rs 11000 for this insurance. I do not have claim experience and i have not taken any cashless treatment. I have a coverage of Rs 5 lakhs which is satisfactory.
      Was this review helpful? 0
      , faridabad
      Reviewed on Feb 14, 2018
    • Religare Health Insurance
      "Average service"
      0.5 3.0/5 "Satisfactory"
      I hold a health insurance with Religare from last 3 years and it is average policy to use. This policy has to be renewed every year and i pay a premium of Rs 18000 for this insurance policy. My claim experience was not up to the mark because they do not cover non hospitalisation bills. I have a coverage of Rs 7 lakhs which is satisfactory.
      Was this review helpful? 0
      , new delhi
      Reviewed on Feb 07, 2018
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