What is restoration benefit in health insurance?
Restoration benefit in health insurance - Importance, types and points to note before claim.
July 11, 2022
Claim settlement ratio (2019-20)
Total GHI lives insured (2020-21)
Total GHI claims incurred (2020-21)
Rs. 684.9 crores
SBI General Insurance Company Limited, a joint venture between State Bank of India and Insurance Australia Group (IAG), started offering its service from 2010 and has been able to be the most promising insurance provider over the years. The company offers a range of insurance products in the categories of motor, group health, home, and travel. SBI General Insurance Company is also known for providing the best corporate insurance products along with rural and liability insurance products.
SBI group health insurance started out with the vision of becoming India’s most trusted insurance company. The company strives to achieve its goal by providing simple yet innovative group health insurance to its customers. For instance, it has unique products like Arogya Shield which provides both health and life insurance covers, and loan insurance policy which provides coverage for critical illness, job loss, and personal accidents.
Just by purchasing your SBI group health insurance from Pazcare, you are choosing to get the best service for your employee. All your administration work can be managed in a hassle-free manner with the Pazcare dashboard. Trusted by more than 500+ companies in India, you can manage the policy, add/delete employees, and manage endorsements by just using the user-friendly Pazcare dashboard. Set your insurance on autopilot now with Pazcare.
Looking for SBI group health insurance? Just by following these simple steps, you can purchase your SBI group health insurance online at Pazcare.
For further information, write to us at email@example.com or call our customer care at +91 78291 11300. Alternatively, connect with us on Whatsapp using the number +91 81973 79596.
SBI group health insurance is the preferred choice of many corporations because of its wide offerings and coverages. Here’s why you should choose SBI group health insurance as your insurance partner:
6,000+ network hospitals
SBI Health Insurance has a strong presence of network hospitals with more than 6,000+ hospitals. You can avail of cashless treatment for the illness covered under your health insurance policy. The process of cashless hospitalization at SBI is extremely easy in case of a planned or emergency hospitalization.
iAAA Rating for “Highest Claim Paying Ability”
SBI general insurance has received a rating from IAAA indicating the highest claim paying ability. This shows how credible SBI group health insurance is.
SBI group health insurance offers great customer care with quick assistance. In fact, it has a tab for “Quick Assistance” on the website where the customers can download policy, check claim status, check policy details, and locate the network hospitals.
Transparent & Fast Claim Settlement Process
SBI group health insurance has a super quick and transparent claim settlement process. You do not have to deal with a delayed claim settlement process with SBI.
You can calculate your Claim Settlement Ratio (CSR) by dividing the total number of claims settled by the total number of death claims volume. Higher the ratio, the more reliable the insurer. Therefore, CSR shows the credibility of the insurer.
SBI health insurance is known for its strong tie-ups with its network hospitals across India where one can avail of cashless treatment as per the terms and conditions of your health insurance policy. SBI health insurance has more than 6000 network hospitals in its network. You can easily enjoy a cashless treatment in these hospitals in a hassle-free manner.
SBI group health insurance cashless claim
In order for you to avail cashless claims at SBI group health insurance, the insurance company has made the process extremely hassle-free. Here’s how you can make cashless and reimbursement claims under the SBI group health insurance plan smoothly.
Follow these steps to avail of cashless treatment under your SBI group health insurance plan.
Step 1: Go to the nearest network hospital
For you to avail of cashless treatment, get hospitalized at the nearest network hospital that is under the SBI network.
Step 2: Present identity proofs
Show your health insurance ID card, company ID card, and proof of identity.
Step 3: Fill and submit the pre-authorization form
Make sure you fill up the pre-authorization form, which the hospital will then forward to SBI Health Administration Team (HAT).
Step 4: Request review
Wait till your documents are sent for verification purposes to SBI. After they are done verifying all your details with your policy benefits, SBI will then inform the hospital about the decision.
Step 5: Claim settlement
In the claim settlement process, you really do not have to do anything. Your insurer will settle all your medical bills directly with the hospital. Kindly wait till your claim request gets approved. Once it is approved they will notify you within 60 minutes. SBI will directly settle at the hospital on your behalf.
SBI group health insurance reimbursement claim process
For you to avail reimbursement claim facility under your SBI group health insurance plan, make sure you follow these steps:
Step 1: Get admitted to a non-network hospital
Make sure you get hospitalized and get the treatment from a non-network hospital nearest to your place or of your choice.
Step 2: Payment at the hospital up-front
Clear all the bills at the hospital upfront from where you received the medical treatment.
Step 3: Collect all the documents
Collect all the original bills and supporting documents required. Contact us at firstname.lastname@example.org
Documents required for SBI group health insurance claim settlement
Make sure you submit all these documents for a group health insurance reimbursement claim settlement with SBI.
Original discharge summary document
Step 4: Documents Submission
After you collect all the required documents, submit them to the nearest SBI health insurance branch. Do it under 15 days of discharge.
Step 5: Claim processing
Once you are done submitting all the required documents mentioned above, SBI will validate the documents. SBI will either approve or reject the reimbursement claim process. Once it is settled, it will get deposited in your bank account.
You can also contact us at email@example.com. We will guide you through the whole process. We provide 24X7 claim assistance for your employees.
Make sure you renew your SBI group health Insurance before it expires. It saves you from losing the benefits. Here are all the steps for your renewal process:
Step 1: Contact Pazcare and submit a form containing your personal details like name, company details, employee strength, number of employees you are looking to insure etc.
Step 2: Consultants at Pazcare will reach out to you once you submit the form. Submit the following documents along with the form.
Step 3: You have the option to choose additional add-ons to your existing policy. This includes your dental insurance riders, maternity benefits, and more. Pazcare offers you a wide range of additional add-ons like wellness and therapy sessions, unlimited medical consultations, and several other comprehensive packages.
Step 4: Our consultants will get back to you with competitive quotes for SBI group health insurance. They will quickly go through your claim report and the add-ons you have selected. Your insurance premium might vary from the previous financial year.
Step 5: Now the consultants will put forward the terms and conditions. Once you agree to it, the premium should be paid to the SBI group health insurance policy.
Step 6: With Pazcare, your onboarding is completed within 24 hours. Our team members will reach out to you if any additional information is required from your end.
With the help of Pazcare dashboard, your insurance journey will be seamless and completely hassle-free.
Step 7: Verify all your documents and once done your insurance provider will let you know if any additional documents are required from your end.
Step 8: Once your documents get verified, and the claim has been made per the policy terms and conditions, the payment will be made within 7 working days. Your claim settlement process will be smooth with Pazcare.
Here are some of the main factors that play a vital role in deciding the premium of ICICI Lombard group health insurance.
Your age will be considered while determining your insurance premium. This factor helps in assessing the risk. For instance, younger people have better immunity compared to older people. This results in fewer health risks, and the premium would be relatively lower.
Nature of the job
Risk-averse jobs will have lower insurance premiums in comparison to risky jobs. Therefore, the nature of the job is considered a significant factor while calculating the premium.
The sum insured in a policy is the maximum amount that the insurer will pay for all of the employee's health and medical costs. Simply said, the bigger the insured amount, the higher the premium.
Your Claim history
Your insurer takes into account your claim history while determining the policy's premium. When renewing the insurance, the insurer will review all of the prior claims to determine whether any additional premiums are due.
The cost will go up if you choose to customize your insurance plan with additional coverage. However, the employee is given the option of a typical group health insurance plan.
In-Patient hospitalization expenses
Your SBI group health insurance plans protect you from in-patient hospitalization if you get sick or have an accident. Hospital room rent fees, nurse costs, hospital ICU costs, surgeon costs, operating room costs, etc are some of the expenses covered under your SBI group health insurance.
Pre- hospitalization and post-hospitalization expenses
Under SBI group health insurance plans, cover 60 days of pre-hospitalization and 90 days of post-hospitalization expenses.
You can cover all the maternity-related expenses for a normal and c-section delivery. You just have to opt for a maternity insurance rider under your SBI group health insurance.
Ayurvedic, homeopathic, and Unani medicine coverage
Your SBI group health insurance cover all your ayurvedic, homeopathic, and Unani medicine under its policy. You can opt for this as an add-on to your existing insurance policy.
Accidental hospitalizations coverage
Your SBI group health insurance policy covers any hospitalization costs you incur as a result of a car accident. These hospital stays, however, must be longer than 24 hours. Remember that India is the only country covered.
If you fall sick and have to rush to the hospital, an ambulance facility is covered under your SBI group health insurance plan.
SBI group health insurance plans do not cover you for your unprescribed vitamins, tonics, or any nutritional supplements.
Injuries caused by self-harm
SBI group health insurance does not cover you against any diseases caused by the intention of self-harm.
Treatment arising from the abuse of substances
SBI group health insurance plans do not cover you against the disease or treatment caused due to the abuse of any substances like drugs, alcohol, etc.
SBI group health insurance plans do not cover you against any treatment which is not yet proven.
The appealing benefits of SBI group health insurance make it the most preferred choice for many. Here are some of the benefits discussed:
Easy Portability Option
For instance, if you are not happy with the insurance provided by your current insurance provider, at the time of renewal you can easily switch to a similar SBI group health insurance plan. SBI allows you to continue with a similar SBI group health insurance plan without you losing the benefits of your existing policy.
Wide Range of Sum Insured Options
SBI group health insurance plans is available with a wide sum insured range. The lowest starting price is from Rs. 1 lakh and goes up till Rs. 50 lakh.
Tax benefits with tax exemption Sec 80 D
The premium paid for SBI group health insurance plans are eligible for tax benefits under Section 80D of the Income Tax Act, 1961. However, you need to keep in mind that you can only avail of tax benefits if the premium is paid in any mode other than cash.
Coverage for the entire family
Under SBI group health insurance, you have coverage for your entire family. This safeguards you and your family members against any health emergencies.
Intimate your insurer
Make sure to notify the SBI group health insurer of your claim. In case of emergency, make sure it is within 48 hours or at least 3 days beforehand. This pertains to hospitalization that was prearranged.
Have all the necessary documents ready with you. Your proof of identity - policy number/health insurance ID card, company ID, and a valid unique govt. ID card.
Submission of pre-authorization form
Fill up the pre-authorization form and submit it to the hospital
The claim will be settled directly at the network hospital once all your details are verified.
Contact us for any queries
For any queries or help, contact Pazcare at firstname.lastname@example.org or call us at +91 78291 11300.
Intimate your insurer
Notify the insurer at least three days in advance or within 48 hours of filing your claim. This is in the case of planned hospitalization.
Clear all your bills
Make sure you clear all your bills and collect the original copies of hospital bills, doctor consultation reports, and other essential documents.
Submit all the required documents along with the claim form to the insurer.
The claim will be settled in your bank account directly once all your documents are verified.
Contact us for any queries
For any queries or help, please contact Pazcare at email@example.com or call us at +91 78291 11300. The team will make sure you are given the right solution.
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Why buy a group health insurance
policy online from Pazcare?
For any queries or assistance, reach out to us at any time. We provide 24X7 customer assistance.
SBI group health insurance policy is easy to apply for and buy online from Pazcare. You can either visit the official website of SBI group health insurance or Pazcare to apply and purchase the SBI group health insurance policy that meets your specific needs.
The Claim Settlement Ratio of SBI group health insurance for the Financial Year 2019-20 is 78.00%.
There are over 6,000+ well-equipped network hospitals covered under SBI group health insurance.
The documents required for the reimbursement process at SBI group health insurance are: