Manipal Cigna Health Insurance Claim Settlement Ratio (CSR) & Claim Process

Manipal Cigna Claim Settlement Ratio

99%

Manipal Cigna

94.21%

Industry Average

Health claim settlement ratio is the percentage of claims settled against the total claims received by the insurance company in a given fiscal year. Manipal Cigna has a claim settlement ratio of 99%, as compared to the industry average of 94.21%.

Manipal Cigna Claim Process

Manipal Cigna supports both cashless claims and reimbursement claims. This section covers the information on how to check Manipal Cigna health insurance claim status, fill Manipal Cigna health insurance claim form, and the claim settlement process.

If you are getting hospitalised in a networked hospital, it would be a cashless claim. You should inform the insurance company immediately of your claim
Fill up a pre-authorization form stating the claim details and submit the form to the insurance company
If it is a planned hospitalisation, the form should be filled in and submitted at least 3 to 5 days before being hospitalised. If, on the other hand if the hospitalisation is due to an emergency, fill up the form and submit it within 24 hours of hospitalisation
The insurance company would verify the pre-authorization form and approve the claim
Once the claim is approved you can avail cashless treatments. The medical bills would be settled by the insurance company directly with the hospital
A Manipal Cigna Health Insurance claim form should be filled and submitted with the insurance company along with all the medical documents to complete the claim process

If you are being hospitalised in a non-networked hospital, your claim would be settled on a reimbursement basis
You should inform Manipal Cigna of the claim and then avail treatments
Pay for the medical expenses incurred on your treatments
After being discharged from the hospital, collect the Discharge Summary
Fill up the claim form of Manipal Cigna Health Insurance and submit it along with all the original medical bills and reports. The Discharge Summary should also be submitted to the insurance company
Manipal Cigna would assess the documents submitted, verify the authenticity of the claim and then reimburse the expenses incurred on hospitalisation

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FAQs

Fixed benefit health plans are those wherein the claim amount does not depend on the actual medical expenses incurred. A fixed amount of money is paid which is predetermined at the time of buying the policy.

Yes, you can by as many health insurance plans as you want depending on your coverage requirement.

Health insurance plans of Manipal Cigna are offered for a period of 1 year, 2 years or 3 years. If you choose longer coverage tenure you also get premium discounts.

No, health insurance claims pay for medical expenses incurred in case of hospitalisation. They do not pay for accidental death. However, if you buy personal accident plans, you get a claim for accidental death.

Yes, medical check-ups are required if you opt for sum insured of INR 25 lakhs. Check-ups are usually required at all ages.

Indemnity oriented health insurance plans are those which pay for the actual medical costs which are incurred up to a maximum of the sum insured chosen by the policyholder.

Yes, all health insurance plans allow lifelong renewals without any maximum cover ceasing age. However, for dependent children, the family floater covers them till 23 years of age. Thereafter, they have to be insured under an independent health insurance plan.

Portability means switching from one health insurance plan to another. Porting can be done between the health insurance plans of the same company or between the health insurance plans of different companies. To port, the policyholder should submit a written request with the insurance company at least 45 days before the expiry of the policy under which he/she is covered.

Manipal Cigna’s ProHealth plans allow family floater coverage wherein self, spouse, dependent children and dependent parents can be covered.

Co-payment is a clause which is usually applicable if the insured is 65 years or above. Under co-payment, a part of the claim is paid by the policyholder himself/herself and the insurance company then pays the remaining. So, if the plan has a co-payment of 20% it means that 20% of the claim would have to be paid by the policyholder and the insurance company would pay the remaining 80% of the claim.

A health insurance plan which compensates for the expenses incurred on hospitalization and has no predefined fixed benefits attached to any condition is called an Indemnity Health Insurance Plan. Basically, it works on a cashless reimbursement basis and claim is payable only on hospitalization.