Raheja QBE Group Health Insurance

Raheja QBE Group Health Insurance

Claim settlement ratio (2019-20)

80%

Network hospitals

5000+

Total GHI lives insured (2020-21)

2 Lakhs

Total GHI claims incurred (2020-21)

234 Crores

TPA

External TPA

About Raheja QBE Group Health Insurance Ltd.

A joint venture between Rajan Raheja Group and QBE Insurance, Raheja QBE group health insurance is a customer-centric insurance company, which makes the process of buying insurance ‘as easy as 1-2-3’. Raheja QBE group health insurance is a growth-oriented company that aims to go above and beyond for its customers. 

One of its core features is agility, with which they resolve queries and solve problems quickly. With a hospital network of 5000+, they are spread all over India to provide the best service to their customers. Their motto is ‘No hidden agendas’ as they follow the path of transparency and honesty in their customer experience as well as their offerings.

If you choose to purchase Raheja QBE group health insurance for your employees through Pazcare, you will get to experience the user dashboard, wherein you can easily manage your employees in one place. With easy HRMS integration, endorsing new employees will be a smooth process. 

How to buy Raheja QBE group health insurance at Pazcare?

You can purchase Raheja QBE group health insurance at Pazcare by following these easy steps -

  1. Visit https://www.pazcare.com/ and click on the products drop-down menu to choose group health insurance
  2. After you fill out the form which appears on the right-hand side of your desktop, you are required to mention your details like - your name, phone number, company name, and the number of employees you want to get insurance for. 
  3. After you submit the duly filled form, one of our health insurance consultants will contact you within a day. Inform them of all your requirements to get Raheja QBE group health insurance for your employees.
  4. Post that, we will get back to you with competitive quotes from Raheja QBE group health insurance and a few other insurers. You can compare the different quotes to make an informed decision.
  5. After you have agreed to the terms and conditions of your chosen policy, the payment will be processed.
  6. After successful payment is made, the onboarding process is carried out within 24 hours.

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

Why choose Raheja QBE group health insurance as your insurance partner?

Easy claims process

Raheja QBE has made the claims process as easy as 1-2-3. You can get your claims settled efficiently through their seamless process.

5000+ network hospitals

With 5000+ network hospital chains, your employees can be assured to receive the best treatment from anywhere in India.

Complete transparency

Raheja QBE group health insurance believes in complete transparency in all its products and offerings. 

Customer-oriented approach

With its customer-oriented approach to conducting business, Raheja QBE group health insurance policy keeps its customers on priority and ensures a good customer experience.

Raheja QBE group health insurance claim settlement ratio

A claim settlement ratio is the number of claims settled to the number of claims received by an insurer in a policy year. A higher claim settlement ratio implies the credibility of the insurer. 

Financial Year Claim settlement ratio
2019-20 80%
2018-19 83%

Also Read: Claim Settlement Ratio- Definition, Significance & Types


Network hospitals of Raheja QBE group health insurance

With more than 5000+ network hospitals, Raheja QBE group health insurance provides the best available service to your employees. The long list of network hospitals ensures that your employees can avail their Raheja QBE group health insurance benefits from anywhere in the country. 

Claim Raheja QBE group health insurance

Raheja QBE group health insurance cashless claim

You can apply for a cashless claim for your Raheja QBE group health insurance policy using the following steps.

  1. Go to the nearest network hospital

You can avail cashless claim facility at the nearest network hospital. Visit the network hospital for the same.

  1. Verification of identity

You are required to verify your identity using your policy number or health insurance ID card, a valid ID proof like an Aadhar card, PAN card,  and the company ID at the nearest network hospital.

  1. Submit the pre-authorization form

Once your verification is successful, the next step is to submit the pre-authorization form to Raheja QBE group health insurance. In cases of emergency hospitalization, the form can be submitted within 48 hours of hospitalization. While in the case of a pre-planned hospitalization, it must be submitted 3 days before the hospitalization take place. 

  1. Review of request

After the form is submitted, Raheja QBE group health insurance will review your claim request. The hospital and policyholder will also be notified of the same.

  1. Claim settlement

Once all the formalities are completed and your insurer accepts your claim request, the claim will be settled directly with the network hospital according to the terms and conditions of your insurance policy.

Raheja QBE group health insurance reimbursement claim

If you get hospitalized at a non-network hospital, you can easily apply for the reimbursement claim from Raheja QBE group health insurance. The following steps should be undertaken in such cases. 

  1. Intimate your insurance company

You need to intimate your insurance provider about the hospitalization at the earliest. In case of emergency hospitalization, you can inform the insurer within 48 hours of hospitalization. Whereas, in case of a pre-planned hospitalization inform at least 3 days before the hospitalization.

  1. Settle the hospital bills

After your treatment at a non-network hospital, you need to settle the hospital bills on your own initially.

  1. Collect all the original documents

After the bills are cleared at the hospital, make sure to collect all the original receipts and bills required to file for a reimbursement claim. 

Following documents are required to file for a reimbursement claim -

  • A duly filled claim form
  • Policy copy/health insurance ID card
  • A valid unique ID card (Aadhar card, driving license, etc.)
  • A medical certificate specifying the duration, medical history, and treatment details signed by the doctor in charge.
  • Doctors reference slips for investigations/pharmacy
  • Any other relevant documents.
  1. Submission of the documents

After collecting all the original relevant documents, you need to submit them to the nearest Raheja QBE group health insurance branch within 15 days of discharge from the non-network hospital.

  1. Claim processing

Once the required documents are submitted and processed, the insurer will review the same to reject or approve your reimbursement claim request. This will be done as per the terms and conditions of the policy. Once approved, the claim will be directly 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, to guide you through the whole process. We provide 24X7 claim assistance for your employees. 

Raheja QBE group health insurance renewal process

Renew your Raheja QBE group health insurance with Pazcare using the following steps.

Step 1: Visit us at https://pazcare.com/ and submit a form that requires you to disclose your name, company name, number of employees, work email address, and phone number.

Step 2: After successfully submitting the form, our group health insurance consultants will contact you for the following documents.

  • Active data of employees - name, age, gender, details of dependents (as per the type of policy)
  • Claim analysis report
  • Claim dump report from the insurer/TPA
  • Policy copy

Step 3: If you want to include any add-ons to your existing Raheja QBE group health insurance policy like pre-existing diseases waiting period, restoration benefits, etc, inform our consultants of your requirements. With Pazcare, you can also choose additional health and wellness benefits like therapy sessions, unlimited doctor consultations, comprehensive health check-ups, and many more to your Raheja QBE group health insurance. 

Step 4: One of our consultants will get in touch with you and offer competitive quotes for your Raheja QBE group health insurance. Based on your claim history and the additional riders, your insurance premium will be decided.

Step 5: After agreeing to the terms and conditions of the policy, please proceed toward the payment for your Raheja QBE group health insurance policy.

Step 6: In case, you are purchasing your Raheja QBE group health insurance for the first time with Pazcare, the onboarding process will be carried out within 24 hours of the payment.

Pazcare ensures that your corporate insurance for employees experience is seamless using our employer dashboard. You can efficiently manage, add or delete your employees using the same. 

What is covered under your Raheja QBE group health insurance?

Advance treatment

If an insurer requires advanced treatment like a uterine artery, deep brain stimulation, stem cell therapy, etc, all will be covered under the Raheja QBE group health insurance policy.

Pre-hospitalization expenses

The cost of medicines and any other requirements before hospitalization will be borne by the insurance company.

Domiciliary hospitalization

Expenses incurred due to medical treatment provided at home instead of a hospital will be covered under your Raheja QBE group health insurance policy.

Daycare treatment

If a medical practitioner advises day-care treatment for an insured person, the cost incurred will be covered under Raheja QBE group health insurance.

What is not covered in your Raheja QBE group health insurance?

Gender change surgeries

Raheja QBE group health insurance will not cover any change of gender surgeries. 

Cosmetic surgery

Any type of cosmetic or plastic surgery to change the appearance, other than the ones suggested by a reliable medical practitioner will not be undertaken by Raheja QBE group health insurance.

Dietary supplements

Any supplements including but not limited to vitamins and protein supplements, which can be bought without a prescription will not be payable by Raheja QBE group health insurance.

Evaluation and investigation

All the expenses incurred for medical tests done for investigation or evaluation purposes will not come under Raheja QBE group health insurance.

Also Read: Understanding Pre-Existing Disease In Health Insurance

Raheja QBE group health insurance benefits

Customize your policy

You can customize your Raheja QBE group health insurance policy by choosing to add on benefits in your base policy or increasing the sum insured as well.

Family cover

The employees can choose to add their family members to their Raheja QBE group health insurance too. 

Sum insured

In your Raheja QBE group health insurance, you can increase the sum insured by up to Rs 1 Cr. 

In-patient hospitalization accidents cover

Raheja QBE group health insurance covers an insured person’s hospitalization expenses like OT charges, ICU room charges. etc.

Raheja QBE group health insurance premium

Make sure you use Raheja QBE group health insurance premium calculator to get the right estimate for your policy. To calculate Raheja QBE group health insurance premium, certain parameters are taken into account. Some of them are as follows - 

Average age

The age of employees is required to calculate group health insurance premiums because mature age persons are considered high-risk individuals.

Sum insured

The premium will automatically increase if you choose a higher sum insured in your Raheja QBE group health insurance. 

Type of plan opted

Different types of plans are available to choose from. If family members will be added to your Raheja QBE group health insurance, there is a high chance that the premium amount will increase. This is because the scope of coverage will increase. 

Add-on benefits

Each add-on benefit will increase the premium as more coverage will be provided by Raheja QBE group health insurance. 

Check Out: Navi Group Health Insurance

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Raheja QBE group health insurance claim process

1

Intimate the insurance company

Intimate the hospitalization to the insurer/TPA within 24 hours, in case of emergency and at least 3 days prior in case of a planned hospitalization.

2

Verify your identity

Provide the 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 complete pre-authorization form/cashless claim form and submit it to the network hospital at the earliest.

4

Claim settlement

After successful verification, the claim will be settled directly with the network hospital.

5

Contact us for assistance

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

1

Intimate the insurer

Intimate your insurer within 48 hours, in case of an emergency and at least 3 days prior in case of a planned hospitalization.

2

Settle the bills

Settle the hospital bills and collect the original copies of all the essential documents.

3

Submit the documents

Submit these documents along with the claim form to the insurer/TPA.

4

Claim settlement

Once verified, the claim will be settled in your bank account directly through NEFT.

5

Contact us for assistance

For any claim assistance contact us at support@getpaz.com or call us at +91 78291 11300. We will be happy to assist.

Raheja QBE group health insurance reviews

4.1 / 5

Rating based on
(6596 reviews)

Nalin

5 / 5

The wellness programs was super productive and meaningful. Thanks for amazing session!

Palagati

4.5 / 5

Thank you team for helping us in every step of the claim process. It was super quick.

Shiwangi

5 / 5

Entire claim process was quick and hassle-free. Extremely satisfied.

Manali

5 / 5

Customer support team always stood by our side and answered all our queries. Grateful!

Venugopal

5 / 5

Extremely approachable and helpful customer support team. Thank you for the guidance.

Nancy

4.5 / 5

Super satisfied with all the offerings by Pazcare. Overall, great experience.

Dmello

5 / 5

Impressed by how smooth and user-friendly the Pazcare portal is. Good job on that!

Surendran

5 / 5

Enjoyed all the wellness sessions offered by Pazcare. Super productive!

Subramanyam

4.5 / 5

The team supported us in every step of claim settlement. Thank you for amazing service!

Tyagi

5 / 5

Never experienced such quick claim process. Super thankful for this!

Ravikiran

5 / 5

Thank you customer support team for always being there for us and answering all our queries.

Nikita

5 / 5

Customer support team helped us right from the beginning to the claim settlement process. Great bunch of people. Super helpful.

Saumya

5 / 5

From the onboarding to claim process, the process was super smooth and quick. Overall, great expereince!

Sharma

4.5 / 5

The insurance experience was much better than our previous provider. Great synergy in the team.

Divya

4.5 / 5

Must say, the Pazcare dashboard was really easy to use. It just made our process much easier.

Pranay

5 / 5

Pazcare portal is so smooth and user-friendly. Loved the entire experience.

4.6 / 5

Rating based on
(3023 reviews)

Palagati

4.5 / 5

Thank you team for helping us in every step of the claim process. It was super quick.

Shiwangi

5 / 5

Entire claim process was quick and hassle-free. Extremely satisfied.

Subramanyam

4.5 / 5

The team supported us in every step of claim settlement. Thank you for amazing service!

Tyagi

5 / 5

Never experienced such quick claim process. Super thankful for this!

4.4 / 5

Rating based on
(2193 reviews)

Manali

5 / 5

Customer support team always stood by our side and answered all our queries. Grateful!

Venugopal

5 / 5

Extremely approachable and helpful customer support team. Thank you for the guidance.

Ravikiran

5 / 5

Thank you customer support team for always being there for us and answering all our queries.

Nikita

5 / 5

Customer support team helped us right from the beginning to the claim settlement process. Great bunch of people. Super helpful.

4.8 / 5

Rating based on
(913 reviews)

Nancy

4.5 / 5

Super satisfied with all the offerings by Pazcare. Overall, great experience.

Saumya

5 / 5

From the onboarding to claim process, the process was super smooth and quick. Overall, great expereince!

Sharma

4.5 / 5

The insurance experience was much better than our previous provider. Great synergy in the team.

4.2 / 5

Rating based on
(1267 reviews)

Dmello

5 / 5

Impressed by how smooth and user-friendly the Pazcare portal is. Good job on that!

Divya

4.5 / 5

Must say, the Pazcare dashboard was really easy to use. It just made our process much easier.

Pranay

5 / 5

Pazcare portal is so smooth and user-friendly. Loved the entire experience.

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

Raheja QBE group health insurance customer care number

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

Raheja QBE group health insurance

Raheja QBE group health insurance FAQs

How to apply for a cashless claim for Raheja QBE group health insurance?

You can apply for a cashless claim by verifying your identity through valid identity proofs like a PAN card, company ID card, policy number, etc. After successful verification is done, your insurance provider will directly settle your cashless claim in a network hospital.

What is the Raheja QBE group health insurance customer care number?

You can contact Raheja QBE group health insurance at 1800-102-7723. You can also mail your grievances to customercare@rahejaqbe.com.

Where do I find the Raheja QBE group health insurance network hospital list?

You can check the network hospital list of your Raheja QBE group health insurance by clicking on the mentioned link - https://www.rahejaqbe.com/hospital-locator.

Does the Raheja QBE group health insurance has an internal TPA?

No, Raheja QBE group health insurance has an external TPA.

Is AYUSH benefit available in Raheja QBE group health insurance?

You can avail of the AYUSH benefit as an add-on benefit to your Raheja QBE group health insurance base policy.