What are the timelines of claim settlement under group health insurance?

1Answer

Cashless claims: Within 2 hours from submission of all required documents on email/fax by the hospital to MediAssist TPA
Reimbursement claims: Within 15 days from receipt of all required documents.

Claim Service Guarantee 
Notwithstanding the above, upon the receipt of all required documents and processing of the claim, the offer of settlement will be made to the Insured in any case not later than 30 days maximum. Settlement (payment) of claim will be made within 7 days of receipt of acceptance in response to offer of settlement, failing which penal interest (in compliance with applicable regulations) at a rate of 2% higher than bank rate (prevailing as on the date of the beginning of the financial year in which the claim is reviewed) will be paid, The period of 7 days mentioned above is included in the maximum period of claim settlement (30 days) stated above.

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