Acko Group Health Insurance

Acko Group Health Insurance

Claim settlement ratio (2019-20)

74.09%

Network hospitals

7000+

TPA

External TPA

Total GHI lives insured (2020-21)

50.73 Lakhs

Total GHI claims incurred (2020-21)

64 crores

About Acko group health insurance

One of the fastest-growing insurance companies in India, Acko is India’s first digital insurer started in 2016. It started off with a mission to reduce the paperwork that is linked with insurance. Moreover, Acko aims to design insurance products that are affordable and comprehensive in nature. With a customer base of over 50 million, Acko General Insurance has some of the leading businesses as its partners. To name a few, OYO, Amazon, redBus, and Ola. 

Acko group health insurance has been consistently offering reliable products to cater to different requirements of people with customized group health insurance plans at highly affordable rates. Because of its straightforward and easy-to-understand insurance, Acko has been able to be the most preferred insurer for people looking for valuable services. 

With Pazcare, your Acko group health insurance experience gets better because we provide. the best group health insurance quotes for your employees at the best prices. With our tech-enabled Pazcare dashboard, your function becomes seamless and hassle-free.  

How to buy Acko group health insurance at Pazcare?

These simple steps allow you to purchase Acko group health insurance online at Pazcare.

  1. Visit https://www.pazcare.com/ and click on the products drop down and choose group health insurance
  2. Now, click on the get insurance button and a form should appear on your screen. Fill in the information - your name, work email, phone number, company name, and the number of employees you wish to insure. 
  3. Make sure you submit the form, and our health insurance consultant will contact you within 24 hours. Tell us your requirements like the type of policy, sum insured, and many more clearly to our consultants.
  4. Our consultants will get back to you with competitive quotes from Acko group health insurance and a few other insurers.
  5. After you decide on the insurer and accept the terms and conditions of the policy, you process the payment.
  6. The onboarding process is carried out within 24 hours of making the payment. 

For further information, write to us at support@getpaz.com or call our customer care at +91 78291 11300. Alternatively, connect with us on Whatsapp using the number +91 81973 79596.

Why choose Acko group health insurance as your insurance partner?

By offering comprehensive customized group health insurance plans at affordable rates, Acko group health insurance has consistently been the most preferred insurance partner for a lot of companies. Here’s why you should choose Acko group health insurance as your insurance partner. 

7000+ network hospitals 

Acko group health insurance has tie-ups with over 7000+ network hospitals where you can easily avail cashless treatment. Some of the best hospitals are under Acko’s network like the Forties, Apollo, and Multi Super Speciality hospital Medanta.

Highly rated app with easy access 

Acko being the first digital insurer, it is focused on providing the best online experience to its customers via the Acko app. Several features like claim registrations, teleconsultations, 24x7x365 customer support, discounts on lab tests, medicine delivery, and other features can be easily accessed via the Acko app. 

24x7x365 customer support 

Acko group health insurance provides 24x7x365 customer support to its customers that answer all their queries and help them in the claim settlement process. 

Quick and hassle-free claim settlement process 

With Acko group health insurance, your claim settlement process is made easy and hassle-free. You do not have to stress yourself with the claim process. Just file for a claim process and experience a quick claim settlement process. 

Acko group health insurance claim settlement ratio

Claim settlement ratio (CSR) is simply the ratio between the number of claims settled to the number of claims requested in that financial year by the health insurance company. 

Mathematically, 

Claim settlement ratio = Number of claims settled/Number of claims made*100

Financial Year Claim settlement ratio
2019-20 74.09%
2018-19 86.98%

Network hospitals of Acko group health insurance

Under Acko group health insurance, you have over 7000+ network hospitals where you can claim cashless treatment. Larger the list of network hospitals, the higher the chances for you to find a cashless network hospital near your location at the time of emergency. You can get the best treatment by just going to the network hospital under Acko and filing for a cashless claim.

Claim Acko group health insurance

Acko group health insurance cashless claim

With Acko group health insurance you can make a cashless claim using the following steps.

  1. Go to the nearest network hospital

You can enjoy the cashless claim benefit at a network hospital under Acko group health insurance only. Thus, visit the nearest network hospital for treatment.

  1. Validate your identity

Make sure you confirm your identity using the health insurance ID card or policy number, a valid photo ID like an Aadhar card, voter ID, driving license, etc, and the company ID at the hospital.

  1. Submit the pre-authorization form

Once the above proof is verified, the next step is to submit the pre-authorization form to Acko health insurance. In case of emergency hospitalization, the form is submitted within 48 hours of hospitalization. When it is the case of planned hospitalization, it is submitted 3 days before the hospitalization. 

  1. Review of request

After the form submission, Acko health insurance will review the claim request. Meanwhile, the network hospital will also be notified about the claim decision. You will be notified through an email or a message.

  1. Claim settlement

Once all these processes are successfully completed, the insurer accepts your claim request. The claim is settled directly with the network hospital according to the terms and conditions of your Acko group health policy.

Acko group health insurance reimbursement claim

If you decide to get hospitalized at a non-network hospital, the reimbursement claim from Acko group health insurance can be carried out by the following steps.

  1. Notify your insurance company

It is important to inform your insurer about the hospitalization. In case of emergency hospitalization, inform the insurer within 48 hours of hospitalization. On the other hand, in case of a planned hospitalization inform at least 3 days before the hospitalization.

  1. Settling the bills at the hospital

After you receive the treatment at a non-network hospital, settle all the bills out of your pockets at the hospital.

  1. Collect all the documents

After you are done settling the bills, make sure you have all the original copies of all the required documents to file for a reimbursement claim. 

The documents required to file a reimbursement claim

  • A duly filled claim form
  • Policy copy/health insurance ID card
  • A valid unique identity card (Aadhar card, driving license, etc.)
  • All original medical bills and pharmacy bills, discharge summary, doctor consultation report and prescription papers.
  • A medical certificate specifying the duration, past medical history, and treatment details signed by the doctor in charge.
  • For accidents, FIR or MLC (Medico-Legal Certificate) copy
  • Other relevant documents.
  1. Documents submission

After collecting all the relevant documents, submit them to the nearest Acko health insurance branch within 15 days of discharge. 

    5. Claim processing

Once you submit all the required documents, the insurer will then review it. The insurer might reject or approve the reimbursement claim request. This will be as per the terms and conditions of your Acko group health insurance policy. Once approved, the claim will be settled in your bank account. You will be notified about the claim approval/rejection via SMS or your registered email.

You can also contact us at support@pazcare.com. We will guide you through the whole process. We provide 24X7 claim assistance for your employees. 

Acko group health insurance renewal process

The Acko group health insurance can be renewed easily with Pazcare at the end of your policy term. Here are the steps to renew your Acko group health insurance plan.

Step 1: Get in touch with Pazcare by just submitting a form. The form contains basic details like your name, name of the company, number of employees you wish to insure, work email address, and phone number.

Step 2: Once the form is submitted, our consultants will get back to you. This is not a fresh policy, therefore, you will have to submit the following documents.

  • Active data of the employees - name, age, gender
  • Claim analysis report
  • Claim dump report from the insurer/TPA
  • Policy copies

Step 3: Now in this step, you can choose additional add-ons to your existing policy. Some of the add-ons are dental insurance riders, and maternity insurance riders to your existing policy. Moreover, with Pazcare one can choose a range of additional health and wellness add-ons to your Acko group health insurance. These add-ons include wellness and therapy sessions, unlimited doctor consultations, comprehensive check-ups, and so on.

Step 4: After you decide on the add-ons, our consultants will get back to you with the competitive quotes for your Acko group health insurance. On the basis of your claims report and the add-ons you choose, your health insurance premium will vary from the previous financial year.

Step 5: After you agree to the terms and conditions of the policy and pay the premium for your Acko group health insurance policy, now the policy will be valid for a year after the renewal.

Step 6: If you are purchasing your Acko group health insurance for the first time with Pazcare, the onboarding process will be carried out within 24 hours. Meanwhile, our associate will provide you with all the information to get started with your Acko group health insurance. 

We make sure that your Acko group health insurance experience will be seamless using our Pazcare dashboard. At Pazcare, we make sure your experience is made hassle-free. You can access your policy using Pazcare’s employee app which is available on both the app store and the play store.

How is the Acko group health insurance premium calculated?

The Acko group health insurance premium is directly proportional to the risks involved. There are several factors that influence the premium for your Acko group health insurance. Some of them are discussed below: 

Age 

Age is a significant factor in determining your insurance premium. The more you age, the more premium you will have to pay for your Acko group health insurance. This is because when you are old, you are more prone to illnesses and diseases compared to young people. Therefore, it is recommended to buy your health insurance policy early. 

Add-ons you choose 

Add-ons you opt for are one of the major factors in calculating your insurance premium. Add-on covers are the extra coverage feature that you opt for with your base health insurance plan. The more add-ons you choose, the higher your premium. 

Body Mass Index (BMI)

Body Mass Index (BMI) refers to the ratio of your height and weight. If your BMI is unhealthy, there are higher chances of you getting several diseases like diabetes, heart diseases etc. Hence you are required to pay a higher insurance premium as you will need extra coverage. 

Sum- Insured 

Sum-Insured is referred to as the maximum amount that your insurance company covers in the case of a medical emergency. In simple terms, higher sum insured means higher coverage and therefore higher premiums. 

 

What is covered under your Acko group health insurance?

Your group health policy is personalized according to your requirement. Here is what your Acko group health insurance covers.

In-patient hospitalization 

This is the cost incurred while you are admitted to the hospital for treatment. However, to claim this you must be admitted for in-patient hospitalization for at least 24 hours. 

Worldwide hospitalization

Under your Acko group health insurance, you are not limited to the boundaries of India. You can be hospitalized outside the country, and Acko will bear the hospital bill per the policy's terms.

Day Care treatment covers

All your medical treatments that do not require 24-hour hospitalization come under day care treatment. You can claim for such treatments under your Acko group health plan. For instance, for your treatment like cataract surgery, tonsillitis surgery, etc.

Compassionate visit

Under your Acko group health insurance, the cost of transporting the immediate family member from India to the place where the insured person is hospitalized is covered. 

What is not covered under your Acko group health insurance?

Undisclosed pre-existing diseases

All the undisclosed pre-existing diseases which are later notified are not covered under your Acko group health insurance. 

Dental treatments (unless recommended due to an accident)

All your dental treatments are not covered under Acko group health insurance unless it is recommended after an accident or anything of that sort. 

Cosmetic treatments

All your cosmetic treatments like plastic surgery, liposuction, and botox are not covered in your Acko group health insurance plan.

Cost of treatment after a suicide attempt

Injuries due to self-harm, like suicide, will not be covered under your Acko group health insurance.

Acko group health insurance benefits

Additional health coverage over and above your employer’s cover 

Even though your organization might provide group health insurance, it might not be customized as per your needs. This additional medical insurance will be helpful for you in case you lose your job or switch to a different job. 

Lower premiums 

Your Acko group health insurance plans are low-cost with the integration of technology to reduce operational costs. The benefit is passed on to the employers in the form of lower premiums. 

Coverage from day 01

Your Acko group health insurance provides coverage from day 01, unlike other health insurance plans where you must wait for a fixed time to avail of coverages. This included your maternity benefits and other pre-existing diseases. 

Hassle-free claim process 

The entire administration of your Acko group health insurance is made hassle-free by Acko’s seamless HRMS solution to provide easy policy administration. From your claims to enrollment, it is handled from the app. 

Acko group health insurance claim process

1

Intimate your insurer

Intimate your claim to the insurer. Make sure it is within 48 hours, in case of an emergency, and at least 3 days prior in case of a planned hospitalization.

2

Verify your identity

You should provide proof of identity - policy number/health insurance ID card, company ID, and a valid unique govt. ID card

3

Submit the pre-authorization form

Fill out the pre-authorization form and forward it to the hospital.

4

Claim settlement

Once the details you forwarded are verified, the claim will be settled directly at the network hospital.

5

Contact us for assistance

For any queries, contact Pazcare at support@getpaz.com or call us at +91 78291 11300.

1

Intimate your insurer

Intimate your claim to the insurer within 48 hours. This is in case of an emergency. At at the time of planned hospitalization, at least 3 days prior.

2

Settle your bills

Settle all your bills and collect the original copies of hospital bills, doctor consultation reports, and other essential documents.

3

Submit the documents

Submit all the original documents along with the claim form to the insurer.

4

Claim settlement

The claim will be settled in your bank account directly after it's verified.

5

Contact us for assistance

For any questions or assistance contact Pazcare at support@getpaz.com or call us at +91 78291 11300. We will make sure your problems are resolved.

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Why buy a group health insurance
policy online from Pazcare?

  • Choose the suitable policy with our consulting approach
  • Custom-made plan with health and mental wellness add-ons
  • The tech-enabled Pazcare dashboard to manage endorsements
  • Integrate the dashboard with your HRMS tool

Acko group health insurance customer care number

For any queries or assistance, reach out to us at any time. We provide 24X7 customer assistance.

Acko group health insurance

Acko group health insurance FAQs

What is Acko group health insurance customer care number?

The customer care number of Acko group health insurance is health@acko.com. You can also reach out at 1800 266 2256.

How is the premium of Acko Group Health Insurance policy calculated?

While calculating Acko Group Health Insurance premium, several factors such as the age and number of employees, the location of the organization, and the number of dependents of the employees are considered.

What are the key benefits of Acko group health insurance?

The key benefits of Acko group health insurance are:

  • Wide network of more than 7000+ hospitals
  • Phenomenal customer support
  • Good Claim Settlement Ratio
  • Cover for treatment related to COVID-19
  • Quick claim settlement process.

Are senior citizens covered under the ACKO group health insurance policy?

Yes, senior citizens are covered under your ACKO group health insurance plan. Employees' parents can be added to the health plan as dependents.

What is Acko group health insurance claim settlement ratio?

The Acko group health insurance claim settlement ratio for the financial year 2019-20 is 74.09%.

How to go about Acko group health insurance renewal?

To renew your Acko group health insurance policy, here are the steps to follow.

  1. Get in touch with Pazcare by submitting the form with basic details like company name, number of employees, and phone number.
  2. Our consultants will get in touch with you for relevant documents required for the renewal of your Acko group health insurance
  3. Agree to the terms and conditions of the policy and pay your premium.
  4. Your policy gets activated immediately after the purchase.