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Health Insurance Glossary

Claim Settlement

In health insurance, "claim settlement" refers to the act of an insurer paying money to an insured for hospitalization expenses.

The status of a policyholder's claim is indicated by a claim settlement.

However, it does not provide a complete picture of whether the insurer paid the entire claim amount or only a portion of it. Claim settlement also does not indicate the time spent by the insurer in processing the request from the policyholder.

If a claim settlement is rejected or partial, one must investigate the reason for rejection and, if necessary, write to the grievance team for further review.

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