What is the Claim Settlement Ratio (CSR) of Cholamandalam Health Insurance?

Cholamandalam Health Insurance maintains a strong claim settlement ratio, typically around 94–95%, reflecting its reliability and efficiency in processing and approving customer claims on time.

What does Claim Settlement Ratio mean?

Claim Settlement Ratio (CSR) represents the percentage of claims an insurer settles compared to the total received in a year. A higher CSR indicates better trustworthiness and prompt claim processing.

How does Cholamandalam settle health insurance claims?

Cholamandalam settles claims in two ways: cashless at network hospitals or reimbursement when treated at non-network hospitals. Both methods ensure quick and transparent processing once required documents are verified.

How do I file a cashless claim with Cholamandalam Health Insurance?

Visit any network hospital, present your Cholamandalam Health Card and ID, fill out the pre-authorization form, and wait for insurer approval. The insurer directly pays the hospital for approved medical expenses.

How do I file a reimbursement claim?

Pay your hospital bill, collect all original documents, fill out the claim form from Cholamandalam’s website, and submit it within 15 days of discharge. The approved amount is credited to your bank account.

How long does Cholamandalam take to process a claim?

For cashless claims, approval usually takes 2–4 hours. Reimbursement claims are typically processed within 7–10 working days after receiving all documents and verification.

What documents are required for claim approval?

You’ll need your Health Card, Policy Number, Government ID, Admission Note, Hospital Estimate, Pre-authorization Form, Discharge Summary, and Final Bills for claim verification and settlement.

Can I track my Cholamandalam Health Insurance claim status online?

Yes. Visit the official Cholamandalam website, go to the Claim Status section, enter your policy or claim details, and view real-time updates on your claim progress.

What happens if I’m admitted to a non-network hospital?

If treated at a non-network hospital, pay bills directly and later file a reimbursement claim with supporting documents to get the approved amount refunded to your bank account.

What if my claim gets delayed?

Delays can occur due to incomplete documentation or verification issues. Contact Cholamandalam’s customer care or your insurance advisor to get updates or resolve pending clarifications.

What are common reasons for claim rejection?

Claims may be rejected for missing documents, incorrect details, policy mismatches, non-disclosure of health conditions, or treatment outside policy coverage limits.

Can I reapply if my claim was rejected?

Yes, you can appeal or resubmit your claim with the correct information and additional supporting documents if the rejection was due to documentation errors or missing information.

What should I do in case of a medical emergency?

In an emergency, inform Cholamandalam or your agent within 24 hours of hospitalization. Provide your Health Card, ID proof, and get the pre-authorization form filled for cashless claim approval.

Is pre-authorization mandatory for cashless claims?

Yes. The pre-authorization form helps the insurer verify treatment details and approve cashless claims quickly before hospitalization or soon after admission.

Can I file a claim if I lose my health card?

Yes. You can use your policy number and ID proof instead. Contact customer support to get a duplicate e-card or download it from the Cholamandalam portal.

Are there expenses not covered in cashless claims?

Yes. Non-medical expenses such as food, toiletries, service charges, and administrative fees are typically not covered and must be paid by the insured.

What should I check before submitting my claim?

Ensure all details like name, policy number, hospitalization dates, diagnosis, and bills are accurate, and attach all relevant documents to avoid delays or rejections.

How can I ensure smooth claim approval?

Submit accurate and complete documents, follow timelines, choose network hospitals whenever possible, and stay informed about your plan’s inclusions and exclusions.

Does Cholamandalam offer 24x7 claim assistance?

Yes. Cholamandalam provides round-the-clock claim support to assist customers with emergency hospitalization, documentation, and claim tracking queries.

OneAssure

Health Insurance

Cholamandalam MS General Insurance

Claim Settlement Ratio

Cholamandalam Health Insurance Claim Settlement

Get a Quote

100k+

Happy Customers

12000+

Network Hospitals

93.20%

Claim Settlement Ratio

100k+

Happy Customers

12000+

Network Hospitals

93.20%

Claim Settlement Ratio

About Claim Settlement

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

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 Cholamandalam Health Insurance Claim Settlement Ratio & Process

Pros

Lifelong renewability and flexible plan options.

Quick processing and helpful support team for claim queries.

Wide cashless hospital network across India for easy access.

A strong claim settlement ratio ensures reliable claim outcomes

Cons

Limited awareness of a full cashless hospital list.

Policy wording can be complex for new buyers.

Waiting periods and sub-limits may affect certain claims.

Pros

Lifelong renewability and flexible plan options.

Quick processing and helpful support team for claim queries.

Wide cashless hospital network across India for easy access.

A strong claim settlement ratio ensures reliable claim outcomes

Cons

Limited awareness of a full cashless hospital list.

Policy wording can be complex for new buyers.

Waiting periods and sub-limits may affect certain claims.

Final Verdict

Cholamandalam Health Insurance stands out for its consistent claim settlement record, supported by a wide network of hospitals and customer-friendly assistance. The insurer ensures a smooth claim process, whether cashless or reimbursement, helping policyholders focus on recovery instead of paperwork. Its plans come with useful benefits like lifelong renewability, high...

Cholamandalam Health Insurance stands out for its consistent claim settlement record, supported by a wide network of hospitals and customer-friendly assistance. The insurer ensures a smooth claim process, whether cashless or reimbursement, helping policyholders focus...

Cholamandalam Health Insurance Claim Settlement & Process

Cashless Claim

Get treatment at any of Cholamandalam’s 10,000+ network hospitals without paying upfront. The insurer settles the bill directly with the hospital.

Reimbursement Claim

If treated at a non-network hospital or if you pay upfront, submit the bills and required documents to Cholamandalam for reimbursement.

Cashless Claim

Get treatment at any of Cholamandalam’s 10,000+ network hospitals without paying upfront. The insurer settles the bill directly with the hospital.

Reimbursement Claim

If treated at a non-network hospital or if you pay upfront, submit the bills and required documents to Cholamandalam for reimbursement.

Claim Settlement Process

How to file Cholamandalam MS General Insurance claims?

Document Required for Cholamandalam Health Insurance Claims

Government-Issued Photo ID

Aadhaar, PAN, Passport, Voter ID, or Driving License to confirm the insured person’s identity.

Policy Schedule or Policy Number

Helps the insurer verify your coverage, plan type, and validity.

Doctor’s Admission Note / Consultation Papers

Indicates the medical reason and necessity for hospitalization.

Hospital Estimate Letter

Provides an approximate cost of the planned treatment or surgery.

Pre-Authorization Form (signed by you and the hospital)

Required to obtain approval for cashless treatment in advance.

Discharge Summary and Final Bills

Confirms the treatment received and the total expenses incurred.

Cholamandalam Health Card / e-Card

Serves as proof of your policy during hospital verification.

Government-Issued Photo ID

Aadhaar, PAN, Passport, Voter ID, or Driving License to confirm the insured person’s identity.

Policy Schedule or Policy Number

Helps the insurer verify your coverage, plan type, and validity.

Doctor’s Admission Note / Consultation Papers

Indicates the medical reason and necessity for hospitalization.

Hospital Estimate Letter

Provides an approximate cost of the planned treatment or surgery.

Pre-Authorization Form (signed by you and the hospital)

Required to obtain approval for cashless treatment in advance.

Discharge Summary and Final Bills

Confirms the treatment received and the total expenses incurred.

Cholamandalam Health Card / e-Card

Serves as proof of your policy during hospital verification.

How to Check Status

How to Check Status of Cholamandalam Health Insurance Claims

To check your Cholamandalam Health Insurance claim status, simply visit the insurer’s official website and follow the on-screen instructions. The online tracking system allows you to monitor your claim’s progress, approval stage, and updates in real time, ensuring complete transparency and convenience throughout the process.

How Claim Settlement Ratio is Calculated

Understand What CSR Means

The Claim Settlement Ratio (CSR) shows how efficiently an insurance company settles claims. A higher CSR indicates a more reliable and customer-friendly insurer.

The Simple Formula

CSR = (Total Claims Settled ÷ Total Claims Received) × 100

Example Calculation

If an insurer receives 10,000 claims in a year and successfully settles 9,900, then CSR = (9,900 ÷ 10,000) × 100 = 99%.

What It Means for You

A 99% CSR means the company settles 99 out of every 100 claims, reflecting strong trustworthiness and efficiency in handling customer claims.

Understand What CSR Means

The Claim Settlement Ratio (CSR) shows how efficiently an insurance company settles claims. A higher CSR indicates a more reliable and customer-friendly insurer.

The Simple Formula

CSR = (Total Claims Settled ÷ Total Claims Received) × 100

Example Calculation

If an insurer receives 10,000 claims in a year and successfully settles 9,900, then CSR = (9,900 ÷ 10,000) × 100 = 99%.

What It Means for You

A 99% CSR means the company settles 99 out of every 100 claims, reflecting strong trustworthiness and efficiency in handling customer claims.

Why Cholamandalam Health Insurance Claims Get Rejected

Incomplete or Incorrect Documentation

Claims can be declined if essential documents such as your Aadhaar, PAN, Passport, Voter ID, or Driving License are missing, invalid, or contain incorrect details. Always double-check for accuracy before submission

Mismatch in Identity or Policy Details

Any discrepancy between the insured’s personal information and the details mentioned in the policy records can cause claim delays or rejections. Ensure all records are consistent and updated.

Missing Proof of Age or Relationship

For family or dependent claims, supporting documents like a Birth Certificate, School Marksheet, or valid ID proof (Aadhaar, Passport, PAN) are needed to confirm age and relationship. Incomplete proof can lead to claim non-acceptance.

Unverified Financial or Employment Information

Certain policies may require verification through Salary Slips, Income Tax Returns (ITR), Form 16, or Bank Statements. If these documents are missing or unverifiable, the claim may be rejected.

Incomplete or Incorrect Documentation

Claims can be declined if essential documents such as your Aadhaar, PAN, Passport, Voter ID, or Driving License are missing, invalid, or contain incorrect details. Always double-check for accuracy before submission

Mismatch in Identity or Policy Details

Any discrepancy between the insured’s personal information and the details mentioned in the policy records can cause claim delays or rejections. Ensure all records are consistent and updated.

Missing Proof of Age or Relationship

For family or dependent claims, supporting documents like a Birth Certificate, School Marksheet, or valid ID proof (Aadhaar, Passport, PAN) are needed to confirm age and relationship. Incomplete proof can lead to claim non-acceptance.

Unverified Financial or Employment Information

Certain policies may require verification through Salary Slips, Income Tax Returns (ITR), Form 16, or Bank Statements. If these documents are missing or unverifiable, the claim may be rejected.