Star Health Insurance

Claims Settlement Process for Star Health Insurance

Cashless Claim Procedure during hospitalization
Cashless Claim: a six step process

• Step 1 - Approach the insurance desk at a network hospital. Intimation can be given either through contacting us at 1800 425 2255 / 1800 102 4477 or e-mail us at support@starhealth.in
• Step 2 - Show your Star Health ID card for identification purpose at the hospital reception.
• Step 3 - Submit to the hospital Pre admission investigations and Doctor’s consultation papers.
• Step 4 - Network hospitals will verify your identity and submit duly filled pre - authorization form with Star Health.
• Step 5 - Our doctors verifies all the submitted documents before processing the claim as per terms and conditions. An assigned field doctor may visit the patient at the hospital if required.
• Step 6 - After discharge, the hospital will send the claim documents to the company and the authorized amount will be settled directly to the hospital.

(Note: Non-Payable items would be at the insured's own cost)
a) In case of planned hospitalization:

• Please contact the toll-free help line: 1800 425 2255 / 1800 102 4477
• The hospital will send the duly filled pre-authorization from through hospital portal (or) at the below number (or) Email ID
  • Call : Toll-free FAX: 1800 425 5522 (or)
  • Call : Non Toll-free FAX: 044 -28302200
  • Email : cashless.network@starhealth.in
• Please carry your ID card.

b) Procedures to be followed in case of emergency hospitalization: In case of Emergency like accident or sudden bout of illness may that requires immediate admission to the hospital

• Upon receiving intimation from the insured/insured’s attender, they are contacted by the network hospital
• Customer Care will verify the validity and coverage of the policy
• A field visit doctor is deputed to visit the patient at the hospital if required.
• Our medical team will process the cashless request for the insured person subject to policy terms and conditions.

c) Cashless claim authorization process

• Upon receiving intimation from the insured/insured’s attender, they are contacted by the network hospital.
• Customer Care will verify the validity and coverage of the policy
• A field visit doctor is deputed to visit the patient at the hospital if required
• Our medical team will process the cashless request for the insured person subject to policy terms and conditions.

d) Documents required for cashless claim submission by Hospital

• Health card
• Doctor's consultation papers
• Discharge summary
• Investigation reports (e.g. X-ray, scans, blood report, etc.)
• Pharmacy invoices supported by respective prescriptions
• In cases of accidents, Medico Legal Certificate (MLC) and / or FIR
• KYC documents of the insured if claimed amount exceed Rs.1, 00,000/-

(Note: Documents other than the Health Card should be submitted in original)
When the Insured gives prior intimation about the treatment and the insured pays the expenses himself with the hospital and then claims for a reimbursement of those expenses within 15 days from the date of discharge.

Reimbursement Claims Procedure following hospitalization

Procedure for Reimbursement of Claim

• All claims need to be intimated within 24 hours of hospitalization. Reimbursement facility is available at network hospitals as well as at non-network hospitals
• Avail treatment, settle all bills and file a claim for reimbursement.
• Submit the claim documents to the company within 15 days from the date of discharge.
• To receive the claim form, cite your policy number and intimate Star Health about hospitalization.

Reimbursement Claim Procedure

• Upon discharge, pay all hospital bills and collect all original documents of treatment undergone and expenses incurred.
• Claim form has to be filled in and along with, all the relevant original documents have to be submitted at the nearest Star Office
• We settle the claim in subject to policy terms and conditions.
• Non-Payable items would be at the insured's own cost.

Documents required for reimbursement claim submission

• Copy of Health card
• Duly filled claim form
• Pre admission investigations and Doctor's consultation papers
• Discharge summary from hospital in Original.
• Investigation reports (e.g. X-ray, scans, blood report, etc.)
• Pharmacy invoices supported by respective prescriptions
• Case receipts from hospital, chemist
• In cases of accidents, Medico Legal Certificate (MLC) and / or FIR
• Copy of the KYC documents - NEFT details, Contact number and E-mail ID