• The Star health website contains the list of Network hospitals including Agreed network hospitals
• Search from the network list from our website and locate the nearest network hospital
• For a planned surgery, approach the hospital prior to the date of admission who will send the completed pre-authorization form
• In the Pre-authorization form you are required to furnish your contact number.
• If details are not completely filled, approval of the authorization request may get delayed

• Duly completed claim form including the present address, Contact number and E-mail ID
• Intimation to toll-free number is mandatory before the form is filled.
• Original bills, receipts and discharge certificate/ card from the hospital.
• Original bills from chemists supported by proper Original prescription.
• Receipt and investigation test reports from a pathologist supported by the note from attending medical practitioner/surgeon prescribing the test.
• Nature of operation performed and surgeon's bill and receipt.
• Self-declaration/MLC/FIR in case of accident cases.
• Treating doctor's certificate.
• NEFT and KYC details

Please Note

• All claims including Pre-hospitalization expenses to be submitted within 15 days from the date of discharge
• Post hospitalization claims are to be submitted within 15 days after completion of the period allowed under the policy for post hospitalization.
• If less than 10 in-Patient beds in towns having a population of less than 10, 00,000 and at least 15 in-Patient beds in all other places.
• KYC to be submitted if the amount claimed is more than Rs.1, 00,000/-.

Note: All Claim Documents other than the Health Card should be submitted in original.

In case of an emergency requiring immediate hospitalization, Star Health must be intimated within 24 hours of the illness / hospitalization with the patient’s Star Health ID number or policy number for easy reference. Intimation can be given either through contacting us at 1800 425 2255 / 1800 102 4477 approach the nearest office of Star Health or e-mail us at support@starhealth.in.

In case of loss or theft of card, contact our toll free helpline number 1800 425 2255 / 1800 102 4477 or e-mail us at support@starhealth.in immediately.

A cashless claim allows you to receive treatment at a network hospital without paying upfront, as the insurance company settles the bill directly with the hospital. However, it’s important to note that the cashless claim is subject to the policy terms, which may include specific conditions regarding co-payments and coverage limits. Cashless hospitalisation is available at all network hospitals.

Additionally, many non-network hospitals also provide cashless treatment under the IRDAI's Anywhere Cashless mandate. However, some non-network hospitals may not be able to provide cashless treatment due to various reasons. In such cases, please settle the medical bills directly at the hospital and apply for reimbursement.

Cashless Claim Procedure for Customers During Hospitalisation
 

Cashless Claim: A Six-Step Process

1. Approach the insurance desk at a network hospital and they will intimate Star Health. Meanwhile, you could also notify us by contacting 1800 425 2255 / 1800 102 4477 or by emailing support@starhealth.in

2. Show your Star Health ID card for identification at the hospital's insurance help desk.

3. Submit relevant investigations and doctor's consultation papers to them.

4. The hospital will verify your identity and submit the duly filled pre-authorization form to Star Health.

5. Our doctors will verify the submitted documents for processing the claim, based on the policy's terms and conditions.

6. A field doctor from Star Health may visit the patient at the hospital if required. At the time of discharge, the hospital will send the claim documents to the company, and the final authorized amount will be paid to the hospital.

Note: The cost of non-payable items will be borne by the insured

a) For Planned Hospitalisation
 

1. Intimate us on our toll-free helpline: 1800 425 2255 / 1800 102 4477.

2. Your hospital will send the duly filled pre-authorization form through the hospital portal or via the email cashless.network@starhealth.in.

3. Please make sure you carry a valid Government-issued identity card and the health card issued by Star Health.

b) For Emergency Hospitalisation

(i) In case of emergencies, such as accidents or sudden illnesses, Star Health will provide all necessary assistance to support immediate hospitalisation:
 

1. After the patient is admitted, the insurance desk/the patient/an attender of the patient can notify Star Health.

2. We will verify the policy’s validity and coverage.

3. A field doctor from Star Health may be assigned to visit the patient if required.

4. Our medical team will process the cashless request, subject to the policy’s terms and conditions.

(ii) Cashless Claim Authorization Process:

1. Upon receiving intimation from the insured/insured’s attender, the network hospital will contact them.

2. We will verify the policy’s validity and coverage.

3. If necessary, a field doctor will visit the patient.

4. Our medical team will process the cashless request for the insured based on policy terms.

c) Documents Required for Cashless Claim Submission by the Hospital

- Health card issued by Star Health

- Doctor’s consultation papers

- Investigation reports (e.g., X-ray, scans, blood tests)

- Pharmacy invoices and all relevant bills with prescriptions

- In cases of accidents: Medico-Legal Certificate (MLC) and/or FIR

- KYC documents of the proposer and the patient

- Discharge summary (during Final Approval)

If cashless hospitalisation is not availed/not utilised, you can settle the hospital bills directly and approach Star Health for reimbursement with all original documents. Please refer to “What is a reimbursement claim?” for more details.

If cashless hospitalization is not available at a non-network hospital (which is not listed here), please settle the charges directly with the hospital. Afterwards, submit the complete set of original documents to us for reimbursement. 

You have several options for submitting the claim documents:

Hand them over at the nearest Star Health office or to your advisor. Find your nearest office here https://www.starhealth.in/lookup/branch

Utilize our Customer Portal or Customer App to upload the documents, and then send the full set of original documents via postal mail or courier to our address. 

Your claim will be processed according to the terms and conditions of your policy. 

For any clarifications, please contact our toll-free numbers 1800 425 2255 / 1800 102 4477 at any time.

A co-pay is a fixed percentage of the admissible/payable bill amount that the insured person is required to pay out of pocket when they receive medical treatment. This means that the insured shares a portion of the medical costs with the insurance company.

Example:

Imagine you have a health insurance policy with a co-pay of 10%. If you undergo a medical procedure for which the admissible/payable bill amount is ₹50,000, your co-pay would be calculated as follows:

Admissible/Payable Bill Amount: ₹50,000

Co-Pay Percentage: 10%

To find your co-pay amount:

Co-Pay Amount = Co-Pay Percentage of Admissible/Payable Bill Amount

Co-Pay Amount = 10% of ₹50,000 = ₹5,000

In this case, you would pay ₹5,000 out of pocket, and the insurance company would cover the remaining ₹45,000.

Co-pay plays a role in balancing healthcare costs, fostering a collaborative approach between insurers and the insured.

A health insurance claim refers to the request submitted to your health insurance provider to get reimbursement or payment for covered health expenses. The health insurance claim process involves informing the insurer, gathering necessary documents, and submitting them for review.