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  • Star Health Insurance Claims Procedure

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    Cashless Treatment

    Customer Service

    Medical Coverage

    Claim Experience

    Responsiveness

    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 28 1 2 3 4 5
    • Star Health Health Insurance
      "GOOD"
      0.5 3.0/5 "Satisfactory"
      I am using the health insurance policy with the STAR HEALTH & ALLIED INSURANCE i am holding it from last 2 years but i have not used this policy i have no experience with this policy. This gives the coverage for self also for disease and the illness covers.
      Was this review helpful? 2
      , mumbai
      Reviewed on Oct 16, 2018
    • Star Health Health Insurance
      "Good service"
      0.5 4.0/5 "Great!"
      I have a health insurance poilcy with STAR HEALTH i am not that much satisfied with there service because they don't provide me information which ever i need from them and even support team is not that much good they don't response me properly.
      Was this review helpful? 1
      , bangalore
      Reviewed on Oct 16, 2018
    • Star Health Health Insurance
      "Excellent service"
      0.5 5.0/5 "Blown Away!"
      I have a health insurance policy with STAR HEALTH for long time, i am very happy with the coverage value of the insurance policy, even i have taken the benefit with them like as my wife met with the accident she was admitted in hospital all the medical bills was taken from star health from admit to discharge they only carried all medical bills as i have claim it.i pay premium of 11000 with gst included.
      Was this review helpful? 0
      , chennai
      Reviewed on Oct 15, 2018
    • Star Health Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have a health insurance policy with STAR health from last 2 years, i am happy with the coverage value of this insurance policy. I pay a premium of Rs 18000 for this insurance and it covers up to Rs 5 lacs. I have no claim experience so far with this insurance.
      Was this review helpful? 0
      , chennai
      Reviewed on Oct 11, 2018
    • Star Health Health Insurance
      "Best policy"
      0.5 5.0/5 "Blown Away!"
      My health is insured with STAR health from last 1 year, a premium of Rs 11500 has to be paid for this insurance policy every year. Lots of hospitals are listed in this insurance. There is a cashless treatment facility in this insurance. The coverage value is Rs 5 lacs and i have no claim experience so far.
      Was this review helpful? 0
      , ghaziabad
      Reviewed on Oct 11, 2018
    • Star Health Health Insurance
      "Good overall"
      0.5 5.0/5 "Blown Away!"
      I have taken a health insurance policy from Star health insurance. It is for my family and I. Till date I have not had a claim experience. The medical coverage is for six months. The premium is not costly. The process to buy the policy in smooth and easy.
      Was this review helpful? 2
      , bangalore
      Reviewed on Sep 22, 2018
    • Star Health Health Insurance
      "Average Service"
      0.5 3.0/5 "Satisfactory"
      I was using the health insurance policy with the Star Health. I am paying a premium of 35K per year. On one occasion I claimed the policy and they were able to reimburse only 75% of the amount claimed which wasn't satisfactory.
      Was this review helpful? 4
      , hyderabad
      Reviewed on Sep 15, 2018
    • Star Health Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      My health is insured with STAR health from last 1year and it is a good policy to use. It is a family policy where the coverage value is Rs 3 lacs per individual. I do not have claim experience with this insurance and i pay a premium of Rs 15000 for this insurance.
      Was this review helpful? 1
      , coimbatore
      Reviewed on Sep 12, 2018
    • Star Health Health Insurance
      "Start Health Insurance Fraud"
      0.5 0.5/5 "Unacceptable"
      My father purchased Star health insurance for family safety and was paying premium from last 2 years but when time came insurer refused to give claim stating that throughout the hospitalization and all investigation reports are within normal limits. My brother was admitted in family hospital delhi for 24 hours, doctors diagnosed him and billed approx 13500.
      Was this review helpful? 6
      , new delhi
      Reviewed on Sep 08, 2018
    • Star Health Health Insurance
      "Satisfactory"
      0.5 5.0/5 "Blown Away!"
      Star health is good in the health insurance policy. The medical coverage is good. It is for my family and I and fortunately I had not had a claim experience til date. The premium is normal and there are good benefits too. There is a no claim bonus too.
      Was this review helpful? 2
      , secunderabad
      Reviewed on Sep 06, 2018
    • Star Health Health Insurance
      "Good Policy"
      0.5 5.0/5 "Blown Away!"
      I have my health insured with Star health insurance from last 6 months, i am not aware of the premium amount as my company pays it. The coverage value for this insurance policy is Rs 3 lacs and there was no claim experience so far with this insurance policy.
      Was this review helpful? 1
      , hyderabad
      Reviewed on Sep 05, 2018
    • Star Health Health Insurance
      "Good policy"
      0.5 4.0/5 "Great!"
      I took health insurance from Star health insurance . I have choose this insurance mainly because of convincing premium with too many benefits . This policy covers Cashless hospitalization. , pre diseases coverage . Overall am satisfied with customer care and service. Am getting income tax benefits
      Was this review helpful? 2
      , coimbatore
      Reviewed on Aug 22, 2018
    • Star Health Health Insurance
      "Worst Company Ever Star Health"
      0.5 0.5/5 "Unacceptable"
      After 5 years of continous coverage and premium , my wife was recently has to go Endoscopy operation . To my surpise the STAR co. refused to pay claim and till date i am trying to check each centre and putting up mails to process my claim. The Group is HELL and i don't recommend anyone . No Customer Support update and the backsupport team are the Worst.
      Was this review helpful? 7
      , ghaziabad
      Reviewed on Aug 11, 2018
    • Star Health Health Insurance
      "Best policy"
      0.5 5.0/5 "Blown Away!"
      I have my health insured with Star health from last 3.5 years, i am happy with the coverage value of this insurance policy. I am not aware of the premium amount as my company pays it. My claim experience was good and they covered 100%. It was e-cashless treatment and it can cover up to Rs 12 lakhs.
      Was this review helpful? 2
      , bangalore
      Reviewed on Jul 31, 2018
    • Star Health Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with Star health from last 7 years and it is a good policy to use. A premium of Rs 200 gets auto deducted through ECS. I have no claim experience so far with this insurance policy and the coverage value is good in this insurance policy.
      Was this review helpful? 1
      , chennai
      Reviewed on Jul 26, 2018
    • Star Health Health Insurance
      "Excellent Service"
      0.5 5.0/5 "Blown Away!"
      I had taken this insurance almost three years and it had been a good experience with them so far. I had been making all the payments online and it has been easy in making the payments. One of my friend referred me in taking this insurance and i had directly went to them in taking the insurance policy and it has been a hassle free process.
      Was this review helpful? 3
      , hyderabad
      Reviewed on Jul 20, 2018
    • Star Health Health Insurance
      "Best policy"
      0.5 5.0/5 "Blown Away!"
      I have my health insured with Star health from last 6 months, i pay a premium of Rs 5500 for this insurance policy and it is a family coverage. I have not claimed anything so far from this insurance policy and the coverage value is Rs 10 lakhs.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jul 20, 2018
    • Star Health Health Insurance
      "Best policy"
      0.5 5.0/5 "Blown Away!"
      I have a health insurance policy with Star health from last 15 years and it is a good policy. It is a family policy with the coverage value of Rs 7 lakhs for this insurance. I have no claim experience so far from this insurance and i pay a premium of Rs 4000 for this insurance.
      Was this review helpful? 2
      , chennai
      Reviewed on Jul 18, 2018
    • Star Health Health Insurance
      "Best service"
      0.5 5.0/5 "Blown Away!"
      I took health insurance from Star health insurance . I have choose this insurance mainly because of convincing premium with too many benefits . This policy covers Cashless hospitalization , pre diseases coverage . Overall am satisfied with customer care and service. Am getting income tax benefits
      Was this review helpful? 1
      , vadodara
      Reviewed on Jul 17, 2018
    • Star Health Health Insurance
      "Best policy"
      0.5 5.0/5 "Blown Away!"
      I have a health insurance policy with Star health from last 7 years and it is one of the good insurance policy. I pay a premium of Rs 10000 for this insurance and it is a family heath policy. My claim experience was good and i have claimed 2 times. The coverage value was 90% and it was a cashless treatment.
      Was this review helpful? 2
      , ahmedabad
      Reviewed on Jul 12, 2018
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