Galaxy Health Insurance Company’s
Key Features and Benefits
Galaxy Health Insurance Company Limited, earlier known as Galaxy Health and Allied Insurance Company Limited, is a standalone health insurance provider based in India. It started in 2024 and is headquartered in Chennai, Tamil Nadu.
The company is backed by the TVS family, led by Shri Venu Srinivasan, along with the family of Shri V. Jagannathan. He’s the founder of Star Health & Allied Insurance and was also the CMD of United India Insurance.
Galaxy Health focuses on offering a wide range of health insurance products designed to fit the changing needs of Indian customers. They’re using tech to make things simpler and more efficient. Mr. G Srinivasan is the CEO and MD of the company.
Here are some of the key aspects of Galaxy Health Insurance Company -
| Founded In |
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| Turnover (GWP) |
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| Number Of Policies |
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| Number Of Claims |
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| Claim Settlement Ratio |
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| % Of Complaints Received on Overall Claims |
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| % Of Complaints Received for After-Sales Service |
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| Claims Settled in Less Than 30 Days |
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(Source: Galaxy Health Insurance Company’s website and Public Disclosure for the financial year 2023-2024).
Health insurance is a financial safety net that can lessen the impact of unforeseen medical costs. One of the main benefits? It ensures that unexpected hospital bills won't deplete your savings by helping to cover significant healthcare costs. A few major benefits of Galaxy Health Insurance policies are as follows:
1
Covers the Cost of Inpatient Hospitalisation
Health insurance's ability to provide comfort during hospital stays is one of its main benefits. Coverage for inpatient treatment begins when the patient is admitted to the hospital for a minimum of 24 hours. Often accounting for a significant amount, if not the whole bill, this covers a wide range of costs, including room rent, nursing fees, diagnostic tests, treatments, and other related hospital expenses.
2
Includes Pre- and Post-Hospitalisation Costs
Pre- and post-hospitalization expenses are also covered by Galaxy Health Insurance, for a predetermined number of days prior to and following the hospital stay. There is a catch, though: these costs are only covered if they are directly linked with the disease that necessitated hospitalisation and fall inside the authorised inpatient coverage. As long as it is connected to the inpatient treatment, this guarantees that all associated medical care will be covered.
3
Includes Daycare Treatments
Many surgeries that previously required hospitalisation can now be finished in a few hours because of the quick advancements in medical technology. Daycare treatments prove helpful in this situation. Even when there is no need for an overnight hospital stay, health insurance policies nowadays are made to cover these rapid turnaround procedures, so you won't have to pay for treatments like chemotherapy, gallbladder removal, or hernia surgery.
4
Supports Domiciliary Treatment
What happens if a patient is unable to travel to the hospital? Domiciliary treatment is used when hospital beds are unavailable, whether because of a serious illness or other circumstances. The good news is that most health insurance policies, including Galaxy Health Insurance, give coverage for this type of service. It's a useful safety net that guarantees people get necessary care without having to leave their homes.
5
Offers Preventive Health Checkups
Having health insurance helps you stay ahead of the game and manage expenses once you get unwell. In order to assist policyholders in identifying possible health problems before they worsen, many plans now incorporate preventive health examinations. Rather than waiting for symptoms to appear, this proactive approach to wellness offers peace of mind.
6
Offers No Claim Bonus
Here's an additional benefit: the No Claim Bonus. You receive a reward if you spend a whole policy year without filing a claim. At renewal, this bonus may lower the premium or raise your sum insured. Insurers encourage healthy living in this simple yet astute manner, guaranteeing that your coverage will only improve with time.
7
Provides Tax Benefits
In addition to protecting your health, health insurance provides a useful financial benefit. If certain requirements are fulfilled, the premiums paid may be claimed as a tax deductible under Section 80D of the Income Tax Act. The exact deduction varies according to the policyholder's coverage, with senior citizens and those who insure dependent parents receiving higher benefits. It's a clever method of combining tax savings with health protection.
8
Benefits of Cashless Treatment
The cashless treatment service is yet another noteworthy aspect. In a medical emergency, your insurer pays bills at affiliated network hospitals directly, saving you from having to fend for cash. The entire process will be much less stressful because you won't have to pay up front.
In today's healthcare environment, health insurance serves as more than simply a safety net; it is an essential financial safeguard. It provides comprehensive coverage for everything from hospital stays to preventive care, along with extra benefits like tax deductions and additional layers of security. Having the right insurance plan in place can greatly reduce the stress of unforeseen bills in a world when medical expenses are on the rise.
However, it's crucial to remember that there is no one-size-fits-all approach to health insurance. It is crucial to carefully study the policy documentation because each insurer has a unique set of terms, conditions, and coverage specifics. Before you ever have to make a claim, this helps you understand exactly what is and is not covered.
What is the Galaxy Health Insurance Claim Settlement Ratio?
The Galaxy Health Insurance claim settlement ratio as of March 2024 is 66.67%. (Source: Public Disclosure, FY-2023 -24).
What Is the Claim Process of Galaxy Health Insurance?
There are two main options to think about while submitting a claim to Galaxy Health Insurance:
➔ Cashless Claim
If you seek care at a hospital that is covered by the insurance company, you can use the cashless claim option. Galaxy Health Insurance provides this practical service through affiliations with specific hospitals. You can avoid making upfront payments by selecting one of these approved hospitals, which will settle your medical expenses directly between the hospital and the insurer. You will only be liable for expenses that are not covered by your policy.
Cashless Claim Process
Here’s a step-by-step guide to help you navigate the cashless claim process with Galaxy Health Insurance:
- First, make sure the hospital you’ve selected is part of your insurer’s network and offers cashless treatment.
- Verify that your insurer has a tie-up with the hospital to process cashless claims there.
- Double-check that the hospital is not listed under exclusions for cashless treatment.
- Take time to go through your health insurance policy to understand any potential restrictions or costs you may need to pay out-of-pocket.
- Gather essential documents, such as your policy copy, the proposer’s PAN and Aadhaar, patient identification, medical reports, and doctor’s prescriptions to initiate the claim.
- For emergency hospitalizations, submit your claim within 24 hours of admission. For planned hospitalizations, request cashless treatment at least three to four days in advance.
- Provide all required documents for pre-authorization through the hospital to your insurer. This typically includes your health card, the proposer’s KYC documents (PAN, Aadhaar), patient ID, policy details, and treating doctor information.
- If the pre-authorization process faces delays, you may need to make an advance payment.
- Once you’re ready to be discharged, be sure to gather all necessary documents from the hospital’s insurance desk.
- Keep track of your claim status and promptly respond to any insurer requests for additional documents or clarifications.
- Once your treatment is complete, carefully review the final bill and discharge summary for any uncovered expenses or outstanding payments.
- If any issues arise, don’t hesitate to directly contact your insurer or consult your financial advisor for guidance.
- Before discharge, ensure you settle any costs not covered by your insurance policy.
➔ Reimbursement Claims
You will be responsible for paying the medical bills up front if you receive treatment at a hospital that is not part of your insurer's approved network, or a non-network hospital. You can, however, submit a reimbursement claim after the payment has been paid. Remember that the precise terms and conditions specified in your health insurance policy will determine how much is reimbursed.
Reimbursement Claim Process
If you're opting for treatment at a non-network hospital, here's a step-by-step guide to help you smoothly file a reimbursement claim:
- Start by confirming that the hospital isn’t listed among the excluded or blacklisted healthcare providers under your policy.
- Inform your insurance company within 24 hours of admission to keep the claims process on track.
- Before discharge, gather all your original documents. This includes bills, invoices, discharge summary, medical reports, MRI/X-ray images, and the claim form filled by the hospital.
- Be sure to collect the patient’s case sheet (indoor case papers) and a detailed hospital bill with a clear breakdown of charges.
- Double-check that the patient’s name, gender, and age are correctly mentioned on all documents. Any errors? Get them fixed right away.
- Assemble the necessary documents: your health card, policy copy, proposer’s KYC details (PAN, Aadhaar, passport-sized photo), patient’s ID proof, a signed claim form, the original discharge summary, and specific documents like the IOL sticker or invoice for implantation claims (e.g., knee replacement or cataract surgery).
- Organize everything neatly - keeping copies of all documents in a separate file for your own records.
- Complete the claim form and submit it with all documents to your insurance company.
- Ensure your insurer acknowledges receipt of the original documents.
- Stay in touch with your insurer after submission to track the claim status.
- If any additional documents are requested, send them promptly to avoid delays.
- Once the claim is processed, review the settlement summary carefully, especially for any deductions.
- Finally, if anything seems unclear, don’t hesitate to consult your financial advisor or directly reach out to your insurer for support.
Documents Required for Galaxy Health Insurance Claims
Filing a health insurance claim with Galaxy Health Insurance Company might feel a bit overwhelming at first-but with the right documents in hand, the process becomes much smoother and far less stressful. Whether you’re going for a cashless claim or a reimbursement, here’s what you’ll typically need:
➔ For Cashless Claims:
To ensure a seamless cashless claim process, make sure you have the following documents ready:
- Your health card issued by the insurance company
- Proposer’s KYC documents - this includes the PAN card, Aadhaar card, and a recent passport-sized photo
- Identity proof of the patient undergoing treatment
- KYC details of the insured individual
- Your policy number for authentication
- Full name of the policyholder
- Complete name and residential address of the insured person filing the claim
- A clear description of the illness or injury, along with the recommended treatment or surgery
- Contact information and address of the treating doctor’s clinic or hospital
- The expected date of hospital admission
- A detailed medical history, covering both related and unrelated conditions, because any mismatch with what was disclosed during the initial policy application could lead to a claim denial
➔ For Reimbursement Claims:
If you're filing a reimbursement claim, having the right paperwork from the get-go can make all the difference. Here's a checklist to guide you through what’s needed:
- A valid health card or a copy of your insurance policy
- The proposer’s KYC documents, which include:
- PAN card
- Aadhaar card
- A recent passport-size photograph
- A recent bank statement showing the bank's name, account number, and IFSC code, or a passbook with the latest transaction page. Alternatively, you can submit an original cancelled cheque with the policyholder’s printed name
- Official identity proof of the patient undergoing treatment
- A completed and signed claim form
- All treatment-related documents, such as test reports, medical prescriptions, diagnostic films, and payment receipts
- The original discharge summary issued by the hospital
- For implantation-related claims like cataract surgery or knee replacement, don’t forget to include the IOL (Intra Ocular Lens) sticker and the invoice
Tip: It's always a smart move to reach out to Galaxy Health Insurance Company directly to double-check if any specific documentation or additional steps are required for your claim.
How to Track Your Galaxy Health Insurance Claim Status?
Wondering where your claim stands? Tracking your Galaxy Health Insurance claim is easy and straightforward. Simply visit the official portal: https://www.galaxyhealth.com/claims/cashless-claim or https://www.galaxyhealth.com/claims/reimbursement-claim. Or mail them at support@galaxyhealth.com. Do you prefer a more personal touch? You can also speak directly with their support team by calling 1800 203 0007. The customer care team is there to assist you and will gladly guide you through the process if you need any help.
Read this - Galaxy Health Insurance
In Conclusion
As of March 31, 2024, the Galaxy Health Insurance claim settlement ratio is 66.67%. Whether it’s a cashless claim or a reimbursement, keeping your documents in order ensures the process stays smooth and stress-free. Ultimately, choosing a reliable health insurance provider like Galaxy Health Insurance goes a long way in making sure that medical emergencies don’t spiral into financial setbacks for you or your loved ones.
FAQ
As per the Public Disclosure for FY 2023-24, Galaxy Health Insurance Company has recorded an impressive claim settlement ratio of 66.67% as of March 2024.
Galaxy Health Insurance Company aims to process and settle claims within 30 days of receiving all necessary supporting documents. However, in cases involving more complex situations, the process may take slightly longer. Notably, during FY 2023-24, the company has settled 100% of claims in under 30 days, underscoring its dedication to quick and efficient claim resolution.
The documents you need to submit for a health insurance claim with Galaxy Health Insurance Company will vary depending on whether you're opting for a cashless or reimbursement claim.
● For cashless claims, you’ll typically need your health card, KYC documents, policy details, and relevant medical reports.
● If you’re filing a reimbursement claim, the insurer usually asks for a completed claim form, policy copy, hospital bills, discharge summary, medical reports, and a cancelled cheque for payment processing.
Yes, pre-existing diseases are covered by Galaxy Health Insurance Company, but only after completing a specific waiting period, as outlined in the policy terms. It’s important to go through your policy document carefully to fully understand the applicable terms and conditions before making a decision.
Yes, a claim can still be rejected even if you hold a valid policy. Simply having coverage doesn’t guarantee approval, your claim must fulfil all the terms and conditions outlined in your policy. Common reasons for rejection include claims related to policy exclusions, incomplete waiting periods, missing essential documents, or not following the insurer’s prescribed guidelines.
Tracking your health claim status with Galaxy Health Insurance Company is quite straightforward. You can check it online through their official website or mobile app, reach out via their customer service helpline, or visit the nearest branch office. Additionally, insurers typically send SMS or email notifications to keep you updated throughout the process, so you’ll always be in the loop.
The claim settlement ratio is shaped by several important factors. It primarily depends on the number of claims received and settled by the insurer, as well as the speed and efficiency of the claim processing. The accuracy and completeness of the documents submitted, along with whether the claim aligns with the terms and conditions of the policy, also play a significant role in determining this ratio.
Not necessarily. While a high claim settlement ratio reflects an insurer’s overall reliability and track record in settling claims, it doesn't guarantee that your individual claim will be approved. Each claim is carefully evaluated based on the policy’s specific terms, applicable exclusions, and the authenticity of the submitted documents.
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