scorecardresearchHealth insurers take an average of 46 days to settle hospital claims, report

Health insurers take an average of 46 days to settle hospital claims, report says

Updated: 18 Apr 2022, 03:55 PM IST

Health insurers take on an average of 20-46 days to settle claims by their clients. This means that you must have a separate fund in place to pay for your hospitalization and subsequent treatment. 

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A study carried out by the insurtech platform SecureNow and published in the Business Standard revealed, “Settlement of expense reimbursement claims under health insurance policies on an average takes about 20 to 46 days from the date of intimation to the insurer.”

Industry details compiled underscore how patients are prompt when it comes to sharing claim details with the insurance companies with most of them intimating the insurers within a week of being hospitalized. The insurer broker shared, “However, on the other hand, the insurance companies take on an average between 7 to 108 days to settle the claims related to maternity. Caesarean sections take the longest time 9 to 135 days and chemotherapy the shortest period 12-35 days.”

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Interpreting the details taken from both the insured and the insurers, SecureNow said, “While patients do not take a lot of time in intimating the insurer for a claim reimbursement upon being admitted, the average time for an insurer to settle the claims is way longer. In a typical claim processing timeline, the maximum time is taken between intimation and settlement.”

There are roughly 10 million health insurance claims filed every year, thus, underlining the speed at which the health insurance industry is growing. Kapil Mehta, co-founder of SecureNow said, “This in itself is a sign of how the health insurance industry has evolved. The next step is to publish detailed claims information. This shines a light on the strengths and improvement areas in settling claims. Our report is an important step in that direction.”

More than the time consumed in settling claims, the insured realized that the insurance company deducts roughly 12-16 per cent of the claim amount before reimbursing it on grounds of uncovered consumables and administrative expenses. The survey also revealed how the claims could be 30-40 per cent lesser than the insurance policies bought from public firms that charge for the plans as per the General Insurance Public Sector Association (GIPSA) rates as opposed to the services provided by private insurance companies.

First Published: 18 Apr 2022, 03:55 PM IST