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  • 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 11 1 2 3 4 5
    • Religare Health Insurance
      "Best policy"
      0.5 5.0/5 "Blown Away!"
      I have a health insurance policy with Religare from last 1.5 years, a premium of Rs 14000 has to be paid for this insurance policy and it is a family coverage. My claim experience was very good and they covered 100%. Coverage value is Rs 5 lacs +5 lacs (auto refill) for this insurance.
      Was this review helpful? 0
      , ahmedabad
      Reviewed on Sep 12, 2018
    • Religare Health Insurance
      "Good policy"
      0.5 4.0/5 "Great!"
      I have taken health insurance , am satisfied with the premium amount which am making . I am getting benefits of Cashless hospitalization and pre disease cover . Even they listed the network of hospital . Their customer representative explained the policy . Overall am satisfied with this policy.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Sep 05, 2018
    • Religare Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have a health insurance policy with Religare from last 2 years, i am happy with the coverage value of this insurance policy. I have not claimed anything so far from this insurance policy. I am not aware of the premium amount as company pays it. The coverage value of this insurance is Rs 5 lacs.
      Was this review helpful? 0
      , mumbai
      Reviewed on Aug 30, 2018
    • Religare Health Insurance
      "Normal Service"
      0.5 3.0/5 "Satisfactory"
      I've been using the health insurance policy from the Religare. I am paying of 12000, there hasn't been any claim experience with the policy. The policy is offering a coverage of 5 lacs for me me my wife and children.
      Was this review helpful? 1
      , ahmedabad
      Reviewed on Aug 24, 2018
    • Religare Health Insurance
      "Good policy"
      0.5 4.0/5 "Great!"
      From Religare health insurance i have taken health insurance , am satisfied with the premium amount which am making . I am getting benefits of Cashless hospitalization and pre disease cover . Even they listed the network of hospitals . Their customer representative explained the policy . Overall am satisfied with this policy.
      Was this review helpful? 1
      , new delhi
      Reviewed on Aug 22, 2018
    • Religare Health Insurance
      "WORST CLAIM SETTLEMENT AFTER PAYING 8 YEARS PREMIUM"
      0.5 0.5/5 "Unacceptable"
      This is one of the Worst Health Insurance paid total >2 lacs apprx for 8 years. they dnt settle claims they say that some or ther other reasons.. I SUGGEST DNT BUY FROM them its one of the worst insurance company as im a regular premium payer for the year of 2010 to till date ... but no use of them..
      Was this review helpful? 3
      , bangalore
      Reviewed on Aug 20, 2018
    • Religare Health Insurance
      "Excellent Service"
      0.5 5.0/5 "Blown Away!"
      I've a health insurance policy with the Religare. I am paying the premium of 12500 for an year, for the entire family. It offers annual coverage of 5 lacs. I do have a claim experience with the policy on that occasion I was able to claim 59000 and the whole claim process was easy and hassle free.
      Was this review helpful? 2
      , faridabad
      Reviewed on Aug 04, 2018
    • Religare Health Insurance
      "Very Good Service"
      0.5 4.0/5 "Great!"
      IT had been a good experience with them so far, i had been making the premium payments online and it had been easy. The premiums had been paying online and the medical coverage with the insurance also had been good as well. Most of the hospitals has been covered with this insurance policy in my locality.
      Was this review helpful? 0
      , noida
      Reviewed on Jul 30, 2018
    • Religare Health Insurance
      "Good Service"
      0.5 4.0/5 "Great!"
      I've a health insurance policy with the Religare Health Insurance.I have paid a premium of 10000 for the first three years. I do not have any claim experience with the policy so far. It has been a hassle free experience with the policy so far. .
      Was this review helpful? 1
      , mumbai
      Reviewed on Jul 26, 2018
    • Religare Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with Religare from last 10 months, i am happy with the coverage value of this insurance policy. I am not aware of the premium amount as company pays it. I have no claim experience so far with this insurance and the coverage value is Rs 2 lakhs.
      Was this review helpful? 0
      , rajahmundry
      Reviewed on Jul 23, 2018
    • Religare Health Insurance
      "Yet to experience the policy "
      0.5 3.0/5 "Satisfactory"
      I never had claim experience. I have taken this policy for past 3 years. I have taken this policy for my family. I used to pay the premium of Rs. 13000 every year. Most of the hospital are covered in this health insurance. The given sum assured amount is a satisfied one. I did not call the customer care since i don't have any claim need so far.
      Was this review helpful? 0
      , pune
      Reviewed on Jul 23, 2018
    • Religare Health Insurance
      "Worst Health Insurance service provider"
      0.5 0.5/5 "Unacceptable"
      I have paid for a health policy via transaction ID 9912358976 . However their services are so worst that neither I have received any confirmation nor the policy adviser has again spoken to me once payment has been done. Neither their chat nor call services work on a sunday. I am literally fed up with their poor service & want to cancel my payment.
      Was this review helpful? 0
      , chennai
      Reviewed on Jun 24, 2018
    • Religare Health Insurance
      "Good Service"
      0.5 4.0/5 "Great!"
      I've a health insurance policy from the Religare Insurance company. I am paying a premium of 9000 per year. I do not have any claim experience with this policy. Overall it has been a smooth experience with the policy so far. I'll have to wait and see how they respond to my request in future.
      Was this review helpful? 0
      , gurgaon
      Reviewed on Jun 22, 2018
    • Religare Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I was using health insurance policy with Religare from last 2 years, i am happy with the coverage value of this insurance policy. I am satisfied with the claim experience and it was a cashless treatment. I have a coverage value of Rs 3 lakhs for this insurance policy.
      Was this review helpful? 0
      , navi mumbai
      Reviewed on Jun 19, 2018
    • Religare Health Insurance
      "BEST"
      0.5 4.0/5 "Great!"
      From past 7months i am using this health insurance. Documents i have done through the on line. The coverage is for 10k. Per annual i pay of rupees 7-8k. Disease coverage is there. Free medical checkup once in a year is also available in my insurance.
      Was this review helpful? 0
      , new delhi
      Reviewed on Jun 17, 2018
    • 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
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