• Star Health Insurance Claims Procedure

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    Easy claims process and rapid reimbursement of incurred bills on treatments and medical expenses are the things that actually make a good health insurance plan even better. Along with a wide network of more than 5400 hospitals, Star Health & Allied Insurance also offers a very simple claims process that ensures that claimants and patients do not have any inconvenience when it comes to settling their bills.

    Incurred Claim Ratio for Star Health Insurance:

    Incurred claim ratios for health insurers are indicators of how well they are doing and if they have enough financial capability to address the valid claims that are being made. While this ratio is an indicator of the financial health of the insurer, it is also a measure of how lenient or strict an insurer is. The incurred claim ratio for Star 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)
    151387 81455 53.81

    For 2014-15:

    Net Earned Premium (in lakhs INR) Net Claims Paid (in lakhs INR) Incurred Claims Ratio (Percentage)
    101,793 65,106 63.96

    Considering ICR (Incurred Claim Ratios), figures above 50% are indicators of good performance by health insurers. Claim ratios above 50% basically mean that the insurer isn’t rejecting even borderline claims and has enough funding to provide cover for all the policies that it has sold. This good ratio means that Star Health will not be in a tight fix when it comes to meeting claims.

    Claim Scenarios:

    Claim scenarios happen with cashless treatment as well as reimbursement cases. Both options for Star Health Insurance are mentioned in the following sections.

    Cashless Treatment:

    Network hospitals are the ones wherein cashless treatment can be availed under a health insurance plan. The bills generated in such cases are sent across to Star and the policyholder or the claimant doesn’t need to pay anything.

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

    1. Member card should be carried on person, or the policy number and member ID should be provided at the network hospital
    2. Contact the number 1800-425-2255 in case of emergency or planned hospitalisation and fax the pre-authorisation form to the numbers 1800-425-5522 or 044-28302200
    3. 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
    4. Once the balance details are filled up by the hospital, the Pre-Authorisation form will be faxed to Star
    5. The Star 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
    6. In case of pending approval cases, Star 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. A field doctor will be assigned to the policyholder to aid in the hospitalisation procedure
    3. Upon submission of the pre-authorisation form, all communications will be taken care of by Star pertaining to the settlement of the bill
    4. 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:

    Treatments done at hospitals not within the network of Star Health Insurance and treatments which have not been approved for cashless mode can opt for reimbursements. The following process will need to be followed in such cases.

    Procedure to File a Claim:

    1. 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
    2. Collection of all related documents from the hospital to be done

    Documents Required:

    The claim form can be downloaded from Star’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. Star Health 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 the office of Star General Insurance.

    Claims Process for Reimbursement Cases:

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

    1. The in-house medical team of Star reviews the case and documents received at the nearest Star Health office
    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

    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.

    Star Health Insurance Claims Procedure Reviews

  • Page 1 of 23 1 2 3 4 5
    • Star Health Health Insurance
      "Good policy to use"
      0.5 4.0/5 "Great!"
      I have paid Rs,8000 to get the health insurance policy from the STAR HEALTH & ALLIED INSURANCE company. This policy covers 3 members in my family and it gives the medical coverage of Rs,3,00,000 and I never had any claim experience so far and I have got this policy around 5 months ago.
      Was this review helpful? 0
      , new delhi
      Reviewed on Feb 20, 2018
    • Star Health Health Insurance
      "Better"
      0.5 1.0/5 "Really Bad"
      I am having the health insurance policy with the Star health insurance company. Coverage value is around 3 lakh Rupees. I would like to say that the response is fine one for me with them and the customer service is good.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Feb 17, 2018
    • Star Health Health Insurance
      "Good insurance"
      0.5 4.0/5 "Great!"
      I have taken a Health Insurance with Star health,i need not pay any premium amount as its from the company.I get a policy coverage amount of two lakhs per year for five members in a family in a floating basis.I have a claim experience once they had deducted a minimum charges and rest was covered by the company.
      Was this review helpful? 0
      , bangalore
      Reviewed on Feb 09, 2018
    • Star Health Health Insurance
      "Good"
      0.5 4.0/5 "Great!"
      I am having the health insurance policy with the Star insurance company. Response is good one with them and the coverage value is also up to the mark. It provides the coverage for my full family, which is on floating basis.
      Was this review helpful? 0
      , bangalore
      Reviewed on Feb 08, 2018
    • Star Health Health Insurance
      "Good"
      0.5 4.0/5 "Great!"
      I am having the medical insurance policy with the Star general insurance company . Its provided by my organization and the coverage value is around 5 lakh Rupees. It provides the coverage value for myself and my dependents.
      Was this review helpful? 0
      , bangalore
      Reviewed on Feb 07, 2018
    • Star Health Health Insurance
      "Excellent"
      0.5 5.0/5 "Blown Away!"
      Took my health insurance with STAR HEALTH & ALLIED INSURANCE. Still now I have not experienced about the claim benefits. But the plan and policy benefits are really good. I am paying rs 4,000 to rs 5,000 per annum. Overall all the experience with the STAR HEALTH & ALLIED INSURANCE is good.
      Was this review helpful? 0
      , chennai
      Reviewed on Feb 06, 2018
    • Star Health Health Insurance
      "Good policy to use"
      0.5 5.0/5 "Blown Away!"
      I got the health insurance policy from the STAR HEALTH & ALLIED INSURANCE. I have this policy for the past 7years. This policy covers 4 members in the family. The medical coverage amount of Rs,3lakhs is available with this policy. I pay the premium of Rs,21,000 every year to renew the policy.
      Was this review helpful? 0
      , new delhi
      Reviewed on Feb 06, 2018
    • Star Health Health Insurance
      "Good insurance"
      0.5 5.0/5 "Blown Away!"
      I have taken my health insurance with Star Health. Its been 2 years now and the policy covers for my entire family. I never had any claim experience. The medical coverage was good. I am paying yearly 7000 rupees through cheque. The payment options were easy and convenient.
      Was this review helpful? 0
      , bangalore
      Reviewed on Jan 27, 2018
    • Star Health Health Insurance
      "Good Coverage"
      0.5 5.0/5 "Blown Away!"
      I have been paying a premium of Rs.17000 on yearly basis. They have given me a coverage of Rs.4-5 Lakhs for the whole family. The cashless options is available in this Insurance. I have been using this Insurance for the past 2-3 years. The overall experience with it has been pretty good.
      Was this review helpful? 0
      , jaipur
      Reviewed on Jan 23, 2018
    • Star Health Health Insurance
      "Average service"
      0.5 1.0/5 "Really Bad"
      I have taken Health Insurance with Star Health General Insurance.I pay a minimum premium amount debited from the salary account,i have claim experience once with them i am not satisfied at all they had covered only 50% of the bill,its covered including the family members.
      Was this review helpful? 0
      , chennai
      Reviewed on Jan 22, 2018
    • Star Health Health Insurance
      "Good service"
      0.5 5.0/5 "Blown Away!"
      I have taken a Health Insurance with Star Health.The premium amount is 600 paid very month,it gets debited from my salaried account as i have registered for the same.The policy coverage amount is three lakhs.I have no claim experience with them.
      Was this review helpful? 0
      , bangalore
      Reviewed on Jan 19, 2018
    • Star Health Health Insurance
      "Better policy to use"
      0.5 4.0/5 "Great!"
      I have got the health insurance policy with STAR HEALTH & ALLIED INSURANCE Company. I have got this policy around 3 years ago, which was provided by my company. This policy covers 6 member in my family. This policy has the medical coverage up to Rs,2lakhs.
      Was this review helpful? 0
      , chennai
      Reviewed on Jan 18, 2018
    • Star Health Health Insurance
      "Average"
      0.5 3.5/5 "Pretty good"
      I do hold health insurance policy with the Star health insurance company and am holding it from 4.5 years of time. Medical coverage value is around 3 lakh Rupees. I would like to say that the response is not really good one with them till now.
      Was this review helpful? 0
      , new delhi
      Reviewed on Jan 18, 2018
    • Star Health Health Insurance
      "Good Insurance Company"
      0.5 5.0/5 "Blown Away!"
      I had taken a health insurance with Star Health for my family and me. I paid approx 9000 rupees for one year policy. I am happy with the service. The claim experience was average because when I claimed some amount was deducted and requested for lot of documents however they took a very long time to respond.
      Was this review helpful? 0
      , chennai
      Reviewed on Jan 18, 2018
    • Star Health Health Insurance
      "Average"
      0.5 5.0/5 "Blown Away!"
      I had taken a health insurance with Star Health for my family and me. I paid approx 9000 rupees for one year policy. I am happy with the service. The claim experience was average because when I claimed some amount was deducted and requested for lot of documents and took a long time.
      Was this review helpful? 0
      , rohtak
      Reviewed on Jan 16, 2018
    • Star Health Health Insurance
      "Good"
      0.5 4.0/5 "Great!"
      I have a health insurance with Star Health which covers my whole family. I never face any problems on this insurance, it was taken last year. The premium is little bit high compare with the insurance companies. I am paying 15,500 rupees per annum through cheque. The policy coverage was 3L.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jan 13, 2018
    • Star Health Health Insurance
      "Health insurance with Star health"
      0.5 5.0/5 "Blown Away!"
      I have recently taken the health insurance from STAR HEALTH & ALLIED INSURANCE. The yearly premium i have to pay is 10700. the policy covers up to 5 lakhs and even provide cashless treatment. Yearly i have to renew the policy. i make my payment through credit card.
      Was this review helpful? 0
      , noida
      Reviewed on Jan 11, 2018
    • Star Health Health Insurance
      "Good service"
      0.5 5.0/5 "Blown Away!"
      I have taken a Health Insurance with Star Health Insurance.The premium amount is debited from my salaried account.I have received a health card they keep changing the card once in a year.The policy coverage amount is one lakhs, its only for me.Its been four years since I had taken this insurance.
      Was this review helpful? 0
      , bangalore
      Reviewed on Jan 11, 2018
    • Star Health Health Insurance
      "Best insurance policy"
      0.5 5.0/5 "Blown Away!"
      I have taken Health Insurance with Star health Insurance.The premium is 11,000 i pay it through online always i prefer paying it through online.I get a policy coverage amount for an amount of eight lakhs.I have no claim experience with them.I am totally happy with the service provided by Star Health insurance.
      Was this review helpful? 0
      , kolkata
      Reviewed on Jan 11, 2018
    • Star Health Health Insurance
      "Excellent"
      0.5 4.0/5 "Great!"
      I am having the health insurance policy with the Star insurance company and am using it from the last two years of time. It does provide the coverage value of 3 lakh Rupees, which is only for myself. Further, I dont have any claim experience with them till now.
      Was this review helpful? 0
      , jaipur
      Reviewed on Jan 11, 2018
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