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Aditya Birla Health Insurance Co. Limited

Real-time claim tracking · 24/7

Track Your Health Insurance Claim Online

Stay informed at every step of your claim journey — from
submission to settlement. No phone calls. No waiting rooms.

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Track Claims on the go!

Get instant claim alerts on Activ Health App.

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Track Claims

Fill the details for track your claim status

Track Claims on the go!

Get instant claim alerts on Activ Health App. download the app

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5 Ways to Track Your Claim

Choose the channel that works best for you all provide real-time status updates.

Online Portal

Log in to portal with your policy number and view full claim history.

ABHI App

Download the Activ One app for push notifications on every status change.

Email Updates

Automated emails at every milestone — straight to your registered inbox.

SMS Alerts

Instant SMS to your registered mobile on claim status updates.

WhatsApp Chat

Get real-time claim updates via WhatsApp at +91 8828800035

Tip: Keep these handy for faster help:

  • Claim ID
  • Policy Number
  • Insured Member Name
  • Hospital Name (For Cashless)

How Claim Tracking Works Your Complete Journey

From filing to settlement here's exactly what happens at each step of your claim.

Step 01

Intimate

Log in to ABHI Platform (ABHI Website/Activ Health app) using your registered mobile number or send “Hi” to our WhatsApp number +91 8828800035. Go to Claims > Reimbursement Claims and enter Hospitalization details.

Step 02

Documents Submission

Upload the Required Documents (in PDF format) and provide Bank & KYC Details. Once submitted, you’ll receive an acknowledgement number.

Step 03

Track Your Claim

Track your claim via the Activ Health App, ABHI website, or SMS/email. Respond to queries via WhatsApp (Hi to +91 8828800035) or in the app under Claims > Queries.

Step 04

Claim Decision

Your claim will be settled directly into your registered bank account, usually within 15 working days from document submission.

Standard Claim Processing Timelines

Processing times vary by claim type. Here's what to expect at each stage.

Cashless Claim
Direct hospital settlement

Pre-authorization
1 Hours*
Discharge Authorization
3 Hours*
Hospital Settlement
As per MOU with Hospital*
*Disclaimer : The TATs are subject to the receipt of complete information to decide the admissibility of the claim

Reimbursement Claim
Direct bank transfer

Document Submission by Insured (Last document)
within 7 days
Claim Registration & Documents validation
1-2 days
Medical Review and Processing
3–4 days
Expert Medical Review (If applicable)
2-3 days
Bank transfer
2 days
Total (Typical)*
7–15 days
*Disclaimer : The TATs are subject to the receipt of complete information and documents to decide the admissibility of the claim

Delays may occur only when:

You'll be notified if anything is pending, so your claim doesn't remain stuck without clarity.

Documents are missing/unreadable

Investigation is needed (rare)

Bank details are incorrect / transfer fails

Medical clarification is required

  • Documents are missing/unreadable
  • Investigation is needed (rare)
  • Bank details are incorrect / transfer fails
  • Medical clarification is required

See How It Works

A quick walkthrough to help you understand the claims tracking process.

Why ABHI Asks for Documents

Documents help process claims correctly and protect customers from incorrect payments or fraud.

They allow verification of:

Diagnosis and treatment
Hospital bills and receipts
Discharge summary
Bank details (reimbursement)
Prescriptions
Test reports
KYC/identity (where required)

Important:

If something is missing or unclear, we raise a query instead of rejecting immediately — so genuine claims can continue smoothly.

Why Approved Amount May Be Lower

Don't be surprised if the settled amount is less than what you claimed. Here are the most common reasons.

1
Room Rent Limits

insurer pays only the standard market rate for a procedure, not inflated bills.

2
Non-medical expenses

items like attendant charges, toiletries, and consumables may be excluded.

3
Co-payment clause

you bear a fixed percentage (typically 10–20%) of every claim as per policy terms.

4
Deductible amount

if your policy has a deductible, that amount is subtracted before settlement.

5
Policy sub-limits

many policies have room rent, ICU, or specific treatment caps that limit payable amounts.

What it means

If you choose a room category higher than your policy allows, the extra cost is not fully covered.

Simple Example (Improved)

  • Your policy allows ₹5,000/day room rent.
  • You choose a room costing ₹10,000/day.
  • The extra ₹5,000/day and related proportionate expenses are paid by you.
  • This also impacts doctor fees, nursing charges, etc.

What Every Claim Status Really Means

Demystifying insurance jargon — here's plain-English explanations for every status you might see.

Submitted

Claim received by insurer

  • Your claim has been registered in our system
  • A claim ID has been assigned to you
  • Documents are awaiting initial review
  • No action needed from you at this stage

Under Process

Active review underway

  • Claims team is reviewing your documents
  • Policy terms are being verified
  • A decision will be made within SLA timelines
  • Check inbox for any information requests

Query Raised

Action required from you

  • Additional information or documents needed
  • Respond within 15 days to avoid rejection
  • Upload required documents via portal or app
  • Claim processing resumes after your response

Approved

Claim sanctioned

  • Your claim has been fully or partially approved
  • Settlement process has been initiated
  • Amount may differ from claimed — check letter
  • Bank transfer or hospital payment in 2 days

Rejected

Claim not sanctioned

  • Rejection reason will be shared via email/SMS
  • Common reasons: exclusions, non-disclosure, lapsed policy
  • You may dispute within 30 days of rejection
  • Contact grievance cell for escalation

Settled

Payment completed

  • Settlement amount has been transferred
  • Settlement statement issued via email
  • Your claim is now officially closed
  • Retain all documents for future reference

What You Can Do While Tracking Your Claim

Don't just wait — these proactive steps can speed up your claim and prevent delays.

Upload Pending Docs

Check your claim portal for any pending document requests and upload them immediately to avoid delays.

Enable Notifications

Turn on SMS and email alerts so you're instantly informed of any status change or query raised.

Contact Your TPA

If your claim is delayed beyond the SLA, reach out to your Third Party Administrator for a status update.

Maintain Document Copies

Keep digital and physical copies of all submitted documents — you may need them for queries or disputes.

Coordinate With Hospital

For cashless claims, stay in touch with the hospital billing desk to ensure documents are submitted accurately.

Track via App

Use the Activ One mobile app for a real-time timeline view, document checklist, and support chat.

Respond to Queries Fast

Queries that go unanswered for 15+ days may lead to rejection. Respond within 48 hours when possible.

Know Your Rights

You have the right to a detailed rejection reason, dispute resolution, and escalation to IRDAI if needed.

Understanding Claim Statuses

Answers to the most common questions about tracking and managing your claim.