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Aditya Birla Health Insurance Claim Settlement

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About Claim Settlement

About Claim Settlement

The claim settlement ratio is often used to judge an insurance company, but it can be misleading. Each insurer calculates it differently, and it doesn’t always show how well they handle claims or support customers....

Customer Testimonials

Customer Testimonials

Real experiences from our valued customers who have chosen our insurance coverage.

Have been associated with Ruchir and his team… They have provided me excellent guidance in choosing the right plans for myself and my family…

…always been available to assist with any insurance/claim queries.

Nakul N

I want to sincerely thank Sunad for being there for me throughout the entire claim process. He helped me through so many ups and downs, always patient and ready to support when things got tough. I honestly don’t know how I would have managed without his guidance and encouragement. Sunad made a difficult situation feel a lot less stressful, and I’m truly grateful for his kindness and steadfast help.

Prashant Pandey

Had a great experience with them during a difficult time. After my mother’s accident, we had to pay the hospital bill upfront, as cashless wasn’t available. They guided us through the reimbursement process, helped file the claim, and consistently followed up with the insurer until it was settled. Their support with the post-hospitalization claim was equally prompt and thorough.

Jatin Gala

My heartfelt thanks to the OneAssure team for making my insurance claim process effortless. Right from the very first interaction, they demonstrated professionalism, clear communication, and an impressive command of the procedures involved. Their swift updates, timely guidance, and persistent follow-through removed all the stress from what could have been a complicated experience.

Anju Renjith

I am truly grateful for the support and guidance I received in settling my insurance claim. The entire process was handled with great professionalism, clarity, and efficiency. Their prompt response, deep knowledge of the procedures, and consistent follow-ups ensured a smooth and hassle-free experience.

Thank you once again for your invaluable help, highly recommended!

Yogesh Meena

I recently had the pleasure of purchasing health insurance for my parents through this company, and my experience has been exceptional...The team was incredibly patient and took the time to explain every detail to me. No matter how many times I asked questions, they were always calm and thorough in their explanations. Their professionalism and dedication made a significant difference in helping me make an informed decision.

Akash Kumar

OneAssure helped me understand my needs and choose a product that was right for me. There was no pressure tactics or mis-selling. This experience was respectful, informed, and completely stress-free.

Shreya Goyal

Had a great experience with OneAssure during my insurance claim process. A special shoutout to Sunad Raj for his exceptional support, he was professional, responsive, and guided me every step of the way. Thanks to his consistent follow-ups and clear guidance, the entire claim settlement was smooth and hassle-free. Highly recommend OneAssure for their service and transparency!

Sanjay Dakalia

The team is very professional and prompt. I would have all my health and life insurance needs met through them.

Harish Jindal

Very professional service from Ruchir & Aman. They were recommended by a friend who had a positive experience with them. I have taken both health and life policies through them and they have advised me well throughout the process and found the best options available in the market. I had a medical condition due to which it was difficult to find a suitable health policy in the market, however this team was able to find one for me. I would recommend their services to anyone looking to buy health or life insurance.

Siddhartha Saha

Wonderful experience with Prost. Right from suggesting the insurance products to claim process the entire experience hai been seamless. They do not mis-sell and are very transparent. Sundar Raj from the team has been wonderful and ensured prompt guidance.

All the best Ruchir and keep up the good work!

Adarsh Ravindranathan

Our Verdict

Our Verdict on Aditya Birla Health Insurance Claim Settlement Ratio & Process

Pros

User-friendly digital claim submission through app makes reimbursement quicker.

Fast cashless authorization helps reduce waiting time during hospitalization.

Wide network of 8,000+ cashless hospitals simplifies treatment access.

Strong claim settlement ratio (around 96%+) ensures dependable claim approvals.

Cons

Policy wording has limits/sub-limits that need careful understanding.

Some documentation requirements may feel extensive for new users.

Cashless approval can vary based on hospital coordination.

Reimbursement claims may take longer during peak periods.

Final Verdict

Aditya Birla Health Insurance delivers a strong and reliable claim experience, supported by a consistently high claim settlement ratio and an extensive cashless hospital network nationwide. Their digital-first approach, including app-based claim uploads, quick acknowledgment,...

What is Aditya Birla’s Claim Settlement & Process?

Cashless Claim

Get treated at any network hospital without paying upfront. Aditya Birla settles the approved bill directly with the hospital.

Reimbursement Claim

If treated at a non-network hospital or if you pay first, you can submit bills and documents to get reimbursed.

Claim Settlement Process

How to file Aditya Birla Health Insurance claims?

Documents Required for Aditya Birla Health Insurance Claims

Aditya Birla Health Card / e-Card

Proof of active policy.

Government ID

Aadhaar, PAN, Passport, Voter ID, or Driving License.

Policy Schedule / Policy Number

For coverage verification.

Doctor’s Admission Note / Consultation Papers

Reason for hospitalization.

Hospital Estimate Letter

Expected cost of treatment or surgery

Pre-Authorization Form

For cashless approval.

Discharge Summary & Final Bills

Details of treatment and expenses.

How to Check Status

How to Check the Status of Aditya Birla Health Insurance Claims

Tracking your Aditya Birla Health Insurance claim status is simple through their official website. You can monitor updates, progress, and any pending requirements directly online.

Aditya Birla Health Insurance Claim Statistics

96%

8,000+

20 Lakh+ Claims Settled Since Inception

How Claim Settlement Ratio (CSR) Is Calculated

Understand CSR

The Claim Settlement Ratio shows how efficiently an insurer pays claims—the higher the ratio, the more dependable the company.

The Formula

CSR = (Claims Settled ÷ Claims Received) × 100

Example

If an insurer receives 10,000 claims and settles 9,900:

CSR = 9,900 ÷ 10,000 × 100 = 99%

Why It Matters

A 99% CSR means 99 out of 100 claims are settled—indicating strong trustworthiness and good claim-handling performance.

Why Aditya Birla Health Insurance Claims Get Rejected

Incomplete or Incorrect Documentation

Claims may be denied if essential documents like Aadhaar, Passport, PAN, Driving License, or Voter ID are missing or mismatched.

Identity or Policy Mismatch

Any mismatch between ID details (Aadhaar, Voter ID, Passport, Driving Licence) and policy records can cause delays or rejections.

Missing Age or Relationship Proof

Failure to provide supporting documents such as Birth Certificates, Marksheet copies, Aadhaar, PAN, or Passport for age/relationship verification can stall claim approval.

Unverified Employment or Financial Records

Some claims require Salary Slips, ITR, Form 16, or recent Bank Statements. Missing or unverifiable documents may result in claim rejection.

Network Hospitals

Delhi

Delhi

Sir Ganga Ram Hospital

Delhi

Delhi

National Heart Institute

Mumbai

Mumbai

Sir H.N. Reliance Foundation Hospital and Research Centre

Mumbai

Mumbai

Fortis S L Raheja Hospital

Chennai

Chennai

Apollo Speciality Hospital

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Family Health Plan

Family Health Plan

  • One policy covers the entire family

  • High sum insured with cashless care

  • Multiple coverage options based on your family needs

Maternity Health Plan

Maternity Health Plan

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Claim Settlement

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Frequently Asked Questions

Frequently Asked Questions

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