• 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 27 1 2 3 4 5
    • Star Health Health Insurance
      "Good Service"
      0.5 4.0/5 "Great!"
      I've a health insurance policy with the Star Health Insurance Company. It offer health insurance benefits for the Whole full family, I am paying premium of 6000 per year and do not have any claim experience. The service is good. They have partnered with many hospitals in my area . Based on the features it has been a god experience with them.
      Was this review helpful? 0
      , coimbatore
      Reviewed on Jun 21, 2018
    • Star Health Health Insurance
      "Good Service"
      0.5 4.0/5 "Great!"
      I've a health insurance policy with the Star Health. I have claimed this policy for 2 lacs. The whole claim process was easy, after discharge. The service was very good. I am really happy about the service of Star Health and it is a recommendable health insurance policy to have.
      Was this review helpful? 0
      , chennai
      Reviewed on Jun 20, 2018
    • Star Health Health Insurance
      "Excellent"
      0.5 4.0/5 "Great!"
      I am having the health insurance policy with the Star health insurance company. Customer service is good one and their response too. Coverage value is fine one too with the Star health insurance company. I have not faced any such claims with them till now.
      Was this review helpful? 0
      , bangalore
      Reviewed on Jun 20, 2018
    • Star Health Health Insurance
      "Good to have insurance policy"
      0.5 3.0/5 "Satisfactory"
      Idon't have any experience of claim hence i never get a chance to call their customer care. They used to call me for renewing the policy. I can claim about 3.5 lakhs per annum. If i use 10% or not claim the policy, they wont give additional benefits for the next year. Their is a insured amount by 10%. My premium amount will be same but the claim amount they will increase by 10% next year. Cashless treatment is available in this policy
      Was this review helpful? 0
      , noida
      Reviewed on Jun 18, 2018
    • Star Health Health Insurance
      "Average Service"
      0.5 2.0/5 "Expected more"
      I'm using the Star Health insurance policy. I do not have any claim experience yet. I pay a premium of 8000 Per year. They don't send any renewal notifications. Their Service is good. The coverage is 1 lac for whole family per year. They need to improve their notifications and keep the customer posted about important dates.
      Was this review helpful? 0
      , chennai
      Reviewed on Jun 16, 2018
    • Star Health Health Insurance
      "Best Health Insurance policy"
      0.5 5.0/5 "Blown Away!"
      Cashless treatment is available only in cities. In other rural areas, i cannot claim the policy for cashless transaction. In rural side, i have to collect all the bill and claim the policy after i paid my bill. I have claimed the policy once for my father. I used to make the payment of Rs. 7500 for me and any wife. I have already recommended this policy to my friends. I can claim easily and i got the payment as soon as possible if i issue the documents properly.
      Was this review helpful? 0
      , chennai
      Reviewed on Jun 12, 2018
    • Star Health Health Insurance
      "Good service"
      0.5 4.0/5 "Great!"
      Got the health insurance policy with the STAR HEALTH & ALLIED INSURANCE company around 3 years ago. This policy covers 4members in my family. This policy has the coverage amount up to Rs,2,00,000 and I am satisfied with it. The medical coverage and the cashless treatment options are good with the Star health insurance policy.
      Was this review helpful? 0
      , hyderabad
      Reviewed on Jun 12, 2018
    • Star Health Health Insurance
      "Good Service"
      0.5 5.0/5 "Blown Away!"
      I've a health insurance policy with the Star Health. We do not have any experience with the policy. Overall service good. My brother handles the payments for this policy. I am not aware of any other details regarding this policy. It offers coverage for the entire family. I never had any issues with the policy and their services.
      Was this review helpful? 0
      , mumbai
      Reviewed on Jun 08, 2018
    • Star Health Health Insurance
      "Good"
      0.5 3.5/5 "Pretty good"
      I do have the health insurance policy with the Star health insurance company. Coverage value is around 1 lakh Rupees. Customer service is similarly okay , also its not bad too. Response is better one with the Star health insurance company.
      Was this review helpful? 0
      , coimbatore
      Reviewed on Jun 06, 2018
    • Star Health Health Insurance
      "Good Service"
      0.5 5.0/5 "Blown Away!"
      I've been using the Star Health insurance policy for a while. I am paying premium of 16000 per year. The premium amount gets auto debited from my account. I never had any issues with their services. Overall the payment options are really convenient and it is a recommendable policy to have.
      Was this review helpful? 0
      , bangalore
      Reviewed on Jun 05, 2018
    • Star Health Health Insurance
      "Very good service"
      0.5 5.0/5 "Blown Away!"
      I've been using the Medi-Claim policy from Star Health for the past 4 years. I am paying a premium of 12000 per year. I claimed it once during the first year . The claim process was really smooth and hassle free. I never had any issues with their services.
      Was this review helpful? 0
      , coimbatore
      Reviewed on Jun 02, 2018
    • Star Health Health Insurance
      "Good policy to use"
      0.5 4.0/5 "Great!"
      Got a health insurance policy from the Star health and allied insurance company. This policy covers 4members in my family. Here it covers the medical coverage amount up to Rs,10,00,000 and I am satisfied with it. This policy is good to use..
      Was this review helpful? 0
      , chennai
      Reviewed on May 31, 2018
    • Star Health Health Insurance
      "Everyone can avail health insurance"
      0.5 5.0/5 "Blown Away!"
      It was smooth process. They are not refunding the money for the plastic items like syringe items. I had a very good claim experience with them. They have a very good hospital list. If they make it fully cashless transaction it will be good. Then they will get lots of customer. I used to pay the premium of Rs. 11000 for my family. The premium amount is increasing every year.
      Was this review helpful? 0
      , bangalore
      Reviewed on May 31, 2018
    • Star Health Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I have my health insured with Star health from last 5-6 years and it is a good insurance policy. I pay a premium of Rs 26000 for this insurance which is for family. I have a coverage value of Rs 6 lakhs for this insurance and i have not claimed anything so far from this insurance.
      Was this review helpful? 0
      , gurgaon
      Reviewed on May 29, 2018
    • Star Health Health Insurance
      "Good Service"
      0.5 5.0/5 "Blown Away!"
      I've a health insurance policy with the Star Health. I pay a premium of 7000 per year. I do not have any claim experience with the policy. I'll have to wait and see how they respond to my claim requests in the future. As of now this too early to evaluate their services.
      Was this review helpful? 0
      , kolkata
      Reviewed on May 29, 2018
    • Star Health Health Insurance
      "Start Health Insurance - Great Provider"
      0.5 5.0/5 "Blown Away!"
      I have taken this Insurance around 5 year back. So far very happy with their services. The claim resolution is very professional and they don't harass customers. I had to claim few times and in all instance it was settled to my satisfaction. Overall very good medical Insurance provider.
      Was this review helpful? 0
      , mumbai
      Reviewed on May 24, 2018
    • Star Health Health Insurance
      "Very good service"
      0.5 5.0/5 "Blown Away!"
      I've been using the employer provided health insurance from the Star Health Insurance company. The company is paying the premium,I do have a claim experience with the policy. They settled a claim of 75000 and the claim process was easy and hassle free.
      Was this review helpful? 0
      , bangalore
      Reviewed on May 24, 2018
    • Star Health Health Insurance
      "Good Policy"
      0.5 5.0/5 "Blown Away!"
      I hold a health insurance with Star health from last 1 year, i am happy with the coverage value of this insurance policy as they cover up to Rs 5 lakhs. My claim experience was good with this insurance and they covered 70% of the amount. I am not aware of the premium amount as company pays it.
      Was this review helpful? 0
      , hyderabad
      Reviewed on May 23, 2018
    • Star Health Health Insurance
      "Good Policy"
      0.5 4.0/5 "Great!"
      I hold a health insurance policy with Star health from last 8 years, i am happy with the coverage of this insurance policy. My claim experience was good with this insurance and the coverage value was good. I pay a premium of Rs 13013 and they cover up to Rs 3 lakhs.
      Was this review helpful? 0
      , coimbatore
      Reviewed on May 20, 2018
    • Star Health Health Insurance
      "Claim experience was good"
      0.5 5.0/5 "Blown Away!"
      I hold a health insurance from STAR HEALTH & ALLIED INSURANCE and the policy coverage is for 2.5 lakhs. As this is a corporate insurance and the claim experience was really good. I gone for cashless treatment and the procedure was easy and satisfied.I will be applicable for the dependent in the family.
      Was this review helpful? 0
      , chennai
      Reviewed on May 17, 2018
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