Star Health Insurance Claim Process/Form/Reimbursement

What is the Star Health Insurance Claim Process?

The Star Health Insurance claim process works in two ways: cashless and reimbursement. For cashless claims, inform the insurer within the required timelines (24 hours for emergencies, 48 hours for planned admissions), submit the pre-authorization form through the network hospital, and provide ID/KYC so approved bills are settled directly.

For reimbursement, pay the expenses upfront, notify Star Health within 24 hours, collect all original documents, fill out the claim form, and submit everything online or at a branch. After verification, the approved amount is transferred to your bank account. Both methods require timely intimation and the submission of required documents. Remember, for the company to admit liability and process the claim, you must first fulfill all the terms and conditions of your policy.

Introduction

If you’ve bought a health insurance policy from Star Health, the most important thing you need to understand is how to make a claim, step by step. Whether it’s a planned treatment or a medical emergency, you should know what to do, whom to inform, and which documents to keep ready.

This guide will help you understand:

How to file a claim
What the cashless process looks like
How reimbursement works
What documents you must submit

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How To Claim Star Health Insurance?

Star Health Insurance Cashless Claim Process

The cashless claim removes the stress of arranging large sums of money quickly. This process is only available at Star Health’s network hospitals.

A. Offline Process (At the Hospital)

Intimation: You must inform Star Health within 24 hours of an emergency admission. For planned treatment, you must notify them 48 hours beforehand for pre-authorization.
You can also call the 24-hour helpline at 044-69006900 or Toll-Free No. 1800 425 2255. Senior Citizens have a dedicated number: 044 40020888. Always provide your policy number for quick reference.
Produce ID: On admission, show the ID Card issued by the insurer at the hospital helpdesk. Also, be ready with the KYC documents (Identity proof with Address) of the proposer.
Pre-authorization Form: Get the pre-authorization form from the hospital help desk. You must complete the patient information section and submit it back to the desk.
Hospital's Role: The treating doctor will fill in the hospitalization and treatment information. The hospital will detail the expected cost of treatment. The hospital then submits this completed form to the insurer.
Processing: The insurer reviews the request. They might call for additional documents or clarifications if the information is inadequate.
Approval/Rejection: Star Health processes the request based on policy terms, conditions, and exclusions. They will then either approve or reject the request based on its merits.
Discharge: Once you are discharged, you sign the final documents. Star Health settles the covered bills directly with the hospital. This is a crucial part of the simplified Star Health Insurance claim process/form/reimbursement.

Important Note: Denial of a pre-authorization request is not a denial of coverage. If denied, you must pay the hospital bills yourself. You can then submit the claim for possible reimbursement

B. Online Process (Using the Star Health App/Portal)

You can also submit the pre-authorization request directly through their dedicated portal or mobile app. This speeds up the initial intimation step. The rest of the process, including hospital verification and bill settlement, remains the same.

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Star Health Insurance Reimbursement Claim Process

If you receive treatment at a non-network hospital, or if the cashless request is denied for some reason, use the reimbursement method.

Offline and Online Submission:

Intimation: Inform Star Health within 24 hours of hospitalization.
Payment: Pay all the hospital bills and other medical expenses out of your own pocket.
Gather Documents: Collect all necessary original documents. This includes discharge summaries, payment receipts, and test reports.
Submit Claim: You need to complete the Star Health Insurance claim process/form/reimbursement forms. Then submit the physical documents to a nearby Star Health branch office. Alternatively, you can scan and upload the documents through their official customer portal on the website.
Verification and Settlement: Star Health verifies the submitted documents. Once verified, the eligible amount is transferred directly to your bank account.

Crucial Time Limits for Submission:

Type of Claim	Prescribed Time Limit
Hospitalization, day care, and pre-hospitalization expenses	Within 15 days from the date of discharge from the Hospital.
Post-hospitalization expenses	Within 15 days after completion of post hospitalisation period (usually 60-180 days) from the date of discharge.

Note: Star Health will examine and may relax these time limits depending on the merits of the case, but timely submission is best for a quick payout.

Documents Required to File a Star Health Insurance Claim

The right documentation is crucial for approval. Missing even one document can slow down the entire Star Health Insurance claim process/form/reimbursement.

For Cashless Claim

The hospital mostly handles this. You typically only need to provide:

Star Health ID Card or Policy Copy.
Original Photo ID (Aadhar Card, PAN Card, etc.).
KYC (Identity proof with Address) of the proposer.
Completed and signed Pre-Authorization Form (provided by the hospital).

For Reimbursement Claim

This requires a comprehensive set of original documents, including:

Duly completed and signed Claim Form (Part A and Part B).
Original discharge summary/certificate from the hospital.
Original final hospital bill and detailed breakdown of expenses.
Original payment receipts for all expenses paid.
All original investigation reports (X-ray, blood tests, etc.).
Prescription papers and pharmacy bills (original).
Medical certificate from the treating doctor.
First Consultation letter.
NEFT documents (Customer name, Bank Account No., Name of the Bank, IFSC code) for fund transfer.
KYC details of the proposer.

Important Note: Make copies of all documents for your records before submitting the originals to Star Health, as proper organization is important for a quick Star Health Insurance claim process/form/reimbursement. We strongly recommend keeping a digital backup as well.

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Conclusion

Star Health offers a fairly simple claim process for both cashless and reimbursement. Their in-house claims team and 14,000+ cashless hospital network makes treatments accessible. The insurer also provides multiple support channels like WhatsApp, customer care lines, senior-citizen helplines, and branch assistance, which helps during emergencies.

However, considering Star Health’s lower claim settlement ratios, higher complaint volumes, and reported operational inefficiencies, we do not actively recommend their plans and suggest taking help from a qualified and experienced insurance agent who knows the ins and outs of their claim process. Even with a smooth claim process, it's crucial to understand your policy’s exclusions, sub-limits, and waiting periods, as these directly impact whether your claim gets approved.

Frequently Asked Questions

How quickly should I inform Star Health about my hospitalization?

You should inform them immediately. For an emergency, you must notify Star Health within 24 hours of admission. For planned hospitalization, intimation should be sent 48 hours before the admission date.

What happens if my cashless claim is denied?

If your cashless claim is denied, it doesn't mean your claim won't be paid. It simply means the hospital won't receive the payment directly. You will need to pay the hospital bills yourself and then file for a reimbursement claim. You must gather all original documents and follow the reimbursement process for settlement.

Can I use the cashless facility in any hospital?

Yes, but with conditions. Cashless Anywhere initiative allows you to request cashless treatment even at non-network hospitals. However, cashless approval is not automatic and depends on Star Health’s evaluation and the hospital’s willingness to accept the terms. Cashless is not allowed at excluded hospitals. Exception: In a genuine emergency, cashless may be allowed only until stabilization, not for full treatment.

How long does the reimbursement claim take to process?

Once Star Health receives all the correct and complete documents, the verification and approval process typically takes about 7 to 14 working days. Any delay is usually due to missing information or incorrect forms. Timely and complete submission speeds up the final payment.

Is there a time limit for submitting reimbursement documents?

For hospitalization, day care, and pre-hospitalization expenses, the claim must be filed within 15 days from the date of discharge from the Hospital. Post-hospitalization expenses must be filed within 15 days after post hospitalization (usually 60-180 days) from discharge.

Last updated on: 22 Nov, 2025