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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 29 1 2 3 4 5
  • Star Health Health Insurance
    "Its Good"
    0.5 5.0/5 "Blown Away!"
    I have personal health policy with Star Health, the process was smooth, the premium is economical. They have generated the policy without any hassles, I took family policy for Rs. 5 lakhs. They have cash less facility but they don't have pre existing disease cover. They got tie up with many hospitals.
    Was this review helpful? 0
    , hyderabad
    Reviewed on Dec 13, 2018
  • Star Health Health Insurance
    "Excellent service"
    0.5 5.0/5 "Blown Away!"
    I have been holding my health insurance with Star health & allied insurance from past one year, they have explain me the policy benefit, and they have tie up with many hospital and they have shared me location as well, and the premium amount they have charged me up to 5000 it is nominal and they charge premium on yearly basis.
    Was this review helpful? 0
    , bangalore
    Reviewed on Dec 12, 2018
  • Star Health Health Insurance
    "Good service"
    0.5 4.0/5 "Great!"
    I have been using my health insurance with Star health insurance,there premium they charge is nominal only i use to pay my premium amount on monthly bases and it use to get auto debited with my bank account and they have explain me all policy which is cover in this policy clearly, till now i did not face any issue with this insurance.
    Was this review helpful? 1
    , indore
    Reviewed on Dec 11, 2018
  • Star Health Health Insurance
    "Excellent Service"
    0.5 5.0/5 "Blown Away!"
    I had taken this insurance policy in the last year and i had been paying the premium on an annual basis. The premium amount has not been too much high and the payment method online has been easy. Almost 90% of the hospitals are covered in the locality and there is cash less treatment available as well.
    Was this review helpful? 0
    , chennai
    Reviewed on Dec 07, 2018
  • Star Health Health Insurance
    "Average"
    0.5 4.0/5 "Great!"
    I have taken a health policy with Star Health before 3 years. It covers for the entire family. I have one claim experience which is not good. They need to improve the customer service. The policy coverage is 3L. I think the network of hospitals is limited and not good.
    Was this review helpful? 0
    , bangalore
    Reviewed on Dec 01, 2018
  • Star Health Health Insurance
    "Good Claim experience and fast exprience"
    0.5 5.0/5 "Blown Away!"
    I have medical cover of Rs. 5 lakhs for entire family totally 3 members. I got the medical card. They are providing cash less service, once I met with an accident, at the time they are reachable, the process was easy. I was admitted for 10 days, they taken complete initiative and settled the bills.
    Was this review helpful? 1
    , noida
    Reviewed on Dec 01, 2018
  • Star Health Health Insurance
    "Good for medical issue"
    0.5 5.0/5 "Blown Away!"
    From Star health I got took health policy, they gave me the medical cover of Rs.5 lakhs its cover entire family totally 3 person, they are providing critical illness I am not sure pre existing disease cover. The premium is very good around Rs. 19000.
    Was this review helpful? 0
    , bangalore
    Reviewed on Nov 30, 2018
  • Star Health Health Insurance
    "Excellent service"
    0.5 5.0/5 "Blown Away!"
    I have been holding my health insurance with Star health insurance , it have been more than a year i have been holding this insurance, the premium amount they have charged me on yearly basis, and it is nominal for me , i use to pay through on line and they have tie up with many hospitals.
    Was this review helpful? 1
    , pune
    Reviewed on Nov 27, 2018
  • Star Health Health Insurance
    "Good service"
    0.5 4.0/5 "Great!"
    I have using health insurance with Star health insurance for a while, they have charged me nominal premium amount but the time of claiming they have not given me any fund for my eye check up as i got some problem in the eye so i have did treatment but they said i can not claim i should be waiting for 6 months or 1 year then only i am eligible to claim.
    Was this review helpful? 1
    , hyderabad
    Reviewed on Nov 27, 2018
  • Star Health Health Insurance
    "Should be genuine to the customer"
    0.5 2.5/5 "Just OK"
    Once I faced claim, at the time Star Health was not customer friendly they kept waiting almost full day to settle the claim and there was no clarity. Being the corporative policy they wont disclose about the health benefits. Hence I wont recommend this policy.
    Was this review helpful? 0
    , new delhi
    Reviewed on Nov 26, 2018
  • Star Health Health Insurance
    "Good policy"
    0.5 4.0/5 "Great!"
    I have taken a health insurance policy with Star Health. The services are good and my father had a good experience. I don't have any claim experience. The customer service is good. The agent will intimate early for the policy renewal. The policy coverage is 10L.
    Was this review helpful? 0
    , chennai
    Reviewed on Nov 23, 2018
  • Star Health Health Insurance
    "AVERAGE"
    0.5 3.0/5 "Satisfactory"
    STAR HEALTH & ALLIED INSURANCE is the health insurance policy where i am holding it but i haev no claim experience with this policy. I am using it from past two year where the premium i paid 8-9k. There is a accidental benefits along with the medical coverage is for 5 lakhs for self.
    Was this review helpful? 0
    , mumbai
    Reviewed on Nov 23, 2018
  • Star Health Health Insurance
    "They need to work on customer support"
    0.5 4.0/5 "Great!"
    I have medical cover Rs. 2 lakhs, They have good network of hospital. I got medical card also from the insurance company, But the customer service is not good hence I moved to HDFC ergo health issue. I suggest Star Health to work on the service.
    Was this review helpful? 0
    , bangalore
    Reviewed on Nov 22, 2018
  • Star Health Health Insurance
    "Its necessary for today's time"
    0.5 5.0/5 "Blown Away!"
    Major factor I found in Star Health, they have highest ratio of claim settlement and the premium is reasonable I paid the amount of Rs. 10500 for one year. But the response should be improved because when I inquired policy for my father who already have cardiac heart disease there was no response. But for me the medical cover is around Rs. 10 lakhs. They are doing health check up if I don't take any claim and over the phone call I can request for cash less treatment.
    Was this review helpful? 0
    , new delhi
    Reviewed on Nov 20, 2018
  • Star Health Health Insurance
    "Excellent policy"
    0.5 4.0/5 "Great!"
    I hold a health insurance policy with Star. This policy is taken for my family. They have given me a coverage amount of 3.5 lakhs. They have wide range of hospitals in my locality. I pay the premium amount of Rs. 11500. They are giving a cashless treatment facility anyway i had no claim experience with this policy
    Was this review helpful? 0
    , new delhi
    Reviewed on Nov 18, 2018
  • Star Health Health Insurance
    "Excellent service"
    0.5 5.0/5 "Blown Away!"
    I have a health insurance policy with Star health insurance, the premium i use to pay is up to 13,000 a per year its nominal for me, from past 1 year i have been using this insurance there customer service explain me about policy and i use to pay through on line like they use to send me the link i use to pay it.
    Was this review helpful? 1
    , mumbai
    Reviewed on Nov 16, 2018
  • Star Health Health Insurance
    "Good service"
    0.5 4.0/5 "Great!"
    I have been using my health insurance with Star health insurance,there premium they charge is nominal only i use to pay my premium amount on monthly bases and it use to get auto debited with my bank account and they have explain me all policy which is cover in this policy clearly, till now i did not face any issue with this insurance.
    Was this review helpful? 0
    , bangalore
    Reviewed on Nov 15, 2018
  • Star Health Health Insurance
    "Good service"
    0.5 4.0/5 "Great!"
    I have been holding my salary account from STANDARD CHARTERED bank there service is very good they provide me they don't charge me unnecessarily and they use to update me time to time about this offers. There use to serve me 24/7 whenever i call they assist me very well.
    Was this review helpful? 0
    , chennai
    Reviewed on Nov 15, 2018
  • Star Health Health Insurance
    "Good service"
    0.5 4.0/5 "Great!"
    I have been holding my Health insurance with Star health & allied insurance for two years, there service was good like service team was explaining all benefits and even about the policy very clearly and there is accidental policy up to 3,00,000 like i can redeem it from this insurance and even my wife is using this company insurance,and the premium they had charge me up to 8,000 for an year, and i pay premium through on line.
    Was this review helpful? 0
    , hyderabad
    Reviewed on Nov 01, 2018
  • 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? 3
    , mumbai
    Reviewed on Oct 16, 2018
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