• Religare Health Insurance Claims Procedure

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    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
      "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
    • Religare Health Insurance
      "Awesome"
      0.5 5.0/5 "Blown Away!"
      I am having the health insurance policy with the Religare and am holding it from the last one year of time. I would like to say that the coverage value is good one for me and the premium value is competitive one with the Religare insurance company.
      Was this review helpful? 0
      , bangalore
      Reviewed on Feb 07, 2018
    • Religare Health Insurance
      "Great"
      0.5 5.0/5 "Blown Away!"
      I have been owning a health insurance policy with Religare. This policy is renewed every year and the premium amount to be paid is rs 5000 which is done through Internet banking. I am very much satisfied with the plan benefits and policy coverage.
      Was this review helpful? 0
      , new delhi
      Reviewed on Feb 06, 2018
    • Religare Health Insurance
      "Very Good"
      0.5 5.0/5 "Blown Away!"
      I have a insurance policy with Religare and it is a good insurance policy to use. This policy has to be renewed every year and i pay a premium of Rs 8000 for this insurance. I do not have claim experience. I am satisfied with the benefits and their policy.
      Was this review helpful? 0
      , chennai
      Reviewed on Jan 23, 2018
    • Religare Health Insurance
      "Good insurance policy"
      0.5 4.0/5 "Great!"
      I hold a health insurance policy with Religare from last 3 years and it is a good insurance policy to use. This policy has to be renewed every year and i pay a premium of Rs 16000 for this insurance. I do not have claim experience and i have not taken any cashles treatment. I have a coverage of Rs 5 lakhs which is satisfactory and the benefits are also good in this policy.
      Was this review helpful? 0
      , mumbai
      Reviewed on Jan 17, 2018
    • Religare Health Insurance
      "Coverage is good"
      0.5 5.0/5 "Blown Away!"
      I have been paying Rs.18000 yearly for this Health Insurance. The coverage that is provided by them is for Rs.20 Lakhs. I have been taking this Insurance for the past 5 years and fortunately never had a Claim with them until now. They have cashless option available in this Insurance.
      Was this review helpful? 0
      , noida
      Reviewed on Dec 26, 2017
    • Religare Health Insurance
      "Good insurance policy"
      0.5 4.0/5 "Great!"
      I have a health insurance policy with Religare Health from last 1 month and it is a good insurance policy to use. I pay a premium of Rs 654 per month and it gets deducted through ECS. I have not taken any cashless treatments and i do not have claim experience. I have a coverage of Rs 5 lakhs for health and Rs 10 lakhs for accident. I am overall satisfied wit this policy.
      Was this review helpful? 0
      , new delhi
      Reviewed on Dec 19, 2017
    • Religare Health Insurance
      "Good Coverage"
      0.5 4.0/5 "Great!"
      I felt this is a good Insurance to have for health coverage of yourself and your Family. I took this with Indusind Bank. At present, I am paying Rs.12500 yearly and the coverage they are offering is Rs.15 Lakhs. Now they have increased the premium a little as I have reached 50 years.
      Was this review helpful? 0
      , mumbai
      Reviewed on Dec 07, 2017
    • Religare Health Insurance
      "Overall Fraud Company for paying Claims"
      0.5 0.5/5 "Unacceptable"
      I took this insurance for my Mother in 2014. Since last 3 years there was no claim and everything was smooth . During last Oct-2017 my mother was sick and admitted in hospital. They did not approved cashless claim. When we send documents to claim department then they started asking questions for previous alignment which was in 2012 and was treated with some other insurance company. Now they are asking how that alignment was diagnosed give all outpatient documents. Who will keep records of 5 year old history? Hospital is saying document given to them is sufficient to approve claim. This claim is hardly for few thousands of rupees. I am paying renewal fee in around 40K per year. At time of renewal they are calling several time to get it renew and talking very decently. I wish i can give them 0 rating. Please don't buy any product from this fraud company.
      Was this review helpful? 1
      , varanasi
      Reviewed on Dec 07, 2017
    • Religare Health Insurance
      "Good Medical coverage"
      0.5 5.0/5 "Blown Away!"
      My friend is working with Religare hence I took the health insurance with them. I made the premium around Rs. 6700 it has tenure of one year. It has the medical cover of Rs. 5 lakhs, it covers only for me. They got good tie up with good hospitals, I got E card for the cash less treatment.
      Was this review helpful? 1
      , bangalore
      Reviewed on Dec 02, 2017
    • Religare Health Insurance
      "Excellent health insurance policy to use"
      0.5 5.0/5 "Blown Away!"
      I hold a health insurance policy with Religare health from last 7-8 months and this policy has to be renewed every year. I pay a premium of Rs 18500 on annual basis through online, i am satisfied with the payment options. The customer service was very good and they were helpful, their services was very fast. I have done cashless treatment and the claim experience was good.It is one of the best health insurance policy to use.
      Was this review helpful? 0
      , noida
      Reviewed on Nov 24, 2017
    • Religare Health Insurance
      "poor service of religare"
      0.5 0.5/5 "Unacceptable"
      My relative Mr Satya Praksh Pokhariyal has been admitted in Kaushambi Hospital, Kaushambi on 20.11.2017 but by now approval has not been received. In want of which protocols have not been followed by the hospital. Who is responsible for anything goes adverse?
      Was this review helpful? 1
      , ghaziabad
      Reviewed on Nov 22, 2017
    • Religare Health Insurance
      "Better"
      0.5 3.0/5 "Satisfactory"
      I am having the health insurance policy with the Religare insurance company and the coverage value is good one too. I have not faced any claims with the Religare insurance company . Customer service is good one with the Religare insurance company.
      Was this review helpful? 0
      , chennai
      Reviewed on Nov 21, 2017
    • Religare Health Insurance
      "Excellent service"
      0.5 5.0/5 "Blown Away!"
      I am very much happy about the service of RELIGARE for my health insurance service they provide me a offer of free medical checkup for my whole family which is not given by any health insurance service providers I am paying around 6800 yearly as a premium for my full family and the payments will be through ecs from my salary account it was a best service from RELIGARE health insurance service.
      Was this review helpful? 0
      , surat
      Reviewed on Nov 20, 2017
    • Religare Health Insurance
      "Excellent service"
      0.5 5.0/5 "Blown Away!"
      It was been about two months I have taken the health insurance service with RELIGARE they provide me good offers but I never avail their service much the payments where generally through online it was a wonderful experience with RELIGARE for my health insurance service.
      Was this review helpful? 0
      , kolkata
      Reviewed on Nov 17, 2017
    • Religare Health Insurance
      "Good Protection"
      0.5 4.0/5 "Great!"
      I like medical coverage of Religare health, they are connected with good hospitals in my location. I make the premium of Rs. 8000 per annum, its covers only for me. Its gives the medical cover of Rs. 5 lakhs, I make the payment through online. They are extra benefits are available for the critical illness.
      Was this review helpful? 0
      , new delhi
      Reviewed on Nov 13, 2017
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