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Claim Settlement
Claim settlement in a health insurance company refers to the process of paying eligible claim amounts to the claimants.
When a policyholder raises an admissible claim, the insurance company assesses the claim to check its validity and eligible amount. If the claim is valid, the insurance company pays the eligible amount towards hospitalisation expenses.
If the claim is inadmissible or invalid, the insurer rejects the claim request. In such a case, the aggrieved claimant can reach out to the grievance cell for further review.
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A
- Accident
- Acute Care
- Acute Condition
- Age Limit
- Agent
- Ambulance Cover
- Annual Health Checkup
- Any One Illness
- AYUSH Treatment
B
C
- Cancer Insurance
- Cashless Facility
- Chronic Condition
- Claim
- Claim Settlement
- Claim Settlement Ratio
- Comorbidity
- Congenital Anomaly
- Consumables
- Contract
- Copayment
- Critical Illness
- Cumulative Bonus / No-Claim Bonus (NCB)
D
- Daily Hospital Cash / Daily Cash
- Day Care Treatment
- Deductible
- Discharge Summary
- Domiciliary Hospitalisation
E
F
G
H
I
- Illness
- Indemnity
- Injury
- Inpatient Care / Inpatient Hospitalisation
- Insurance Ombudsman
- Insured Person
- Insurer
- Intensive Care Unit (ICU)
- IRDAI
L
M
N
O
P
- Personal Accident Cover
- Policy Document
- Policyholder
- Portability
- Post-Hospitalisation Expenses
- Pre-Existing Disease (PED) / Pre-Existing Condition
- Pre-Hospitalisation Expenses
- Premium
R
- Reasonable and Customary Charges
- Reimbursement
- Renewal
- Restoration Benefit / Automatic Restoration
- Rider / Add-on Cover
- Room Rent Limit
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