Which company is no 1 in claim settlement ratio?

LIC and private players like Care Health often lead in claim settlement ratios, depending on yearly IRDAI reports.

Which health insurance company approves the most claims?

Insurers with strong cashless networks like Care Health and Niva Bupa usually approve the highest number of claims quickly.

What are signs of a good settlement offer?

A good offer is quick, fair, covers all expenses, needs minimal negotiation, and aligns closely with your documented medical costs.

How much time does it take to settle a health insurance claim?

Most cashless claims are settled in 2–6 hours, while reimbursement claims may take 7–14 days depending on documents and insurer processes.

Do insurance companies want to settle quickly?

Yes, insurers prefer quick settlements to reduce processing costs, avoid disputes, and maintain customer trust.

What are the 4 stages of insurance claims?

The four stages are claim intimation, document submission, assessment and approval, and final settlement or payout.

Can health insurance be claimed immediately?

Yes, cashless claims for emergencies can be filed immediately, while planned treatments may need prior authorisation.

Disclaimer: Jaagruk Bharat is a private organization offering support for documentation and government scheme access. We are not affiliated with any government body. Official services are available on respective government portals. Our goal is to make processes easier and more accessible for citizens.

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Faster Health Insurance Claim Settlement Via Single-Window Platform NHCX Begins: How It Will Help Policyholders?

Q: What is the National Health Claims Exchange Nhcx?

NHCX is a digital platform that standardises claim data exchange between hospitals and insurers to speed up approvals and reduce paperwork.

Komal Bajpai

Author

Updated: 17-11-2025 at 3:30 PM

National Health Claims Exchange (NHCX) is expected to revolutionise the health insurance industry by simplifying, accelerating, and standardising the processes of settling claims for health insurance. This reform in health insurance will enhance the settlement process by facilitating seamless information and document exchange between hospitals and insurance companies. With this new platform, the waiting time for claim settlements will be reduced significantly, thereby enabling faster discharges from hospitals. So, what are some changes that will occur after introducing an NHCX platform to health insurance policyholders?

Overview

Here’s a quick summary of what NHCX is and how it aims to change the health insurance landscape:

Particular	Details
Scheme name	National Health Claims Exchange (NHCX)
Launched by	National Health Authority (NHA), Ministry of Health & Family Welfare
Objective	Simplify and standardise health insurance claim settlement processes
Key participants	Hospitals, insurers, TPAs, policyholders, laboratories, and government scheme administrators
Core functionality	Automated claim verification, adjudication, and data exchange across stakeholders
Integration	Linked with Ayushman Bharat Health Account (ABHA) for digital identity and verification
Regulatory support	IRDAI mandates faster cashless claim settlement (within 3 hours for discharge requests)

Latest News

The National Health Authority (NHA) has completed pilot tests for NHCX in several major hospitals, validating its real-time data transfer capabilities.

The Insurance Regulatory and Development Authority of India (IRDAI) has strengthened its guidelines to mandate that cashless claim discharges must be processed within three hours under this system.

Several private health insurers have already signed up to use NHCX, with plans to expand usage to all their network hospitals.

NHA is reportedly working to onboard state-run hospitals and laboratories onto the platform, ensuring broad participation across public and private healthcare.

What Is The National Health Claims Exchange (NHCX)?

The National Health Claims Exchange (NHCX) refers to a single-window digital platform developed by the National Health Authority (NHA) and the Union Ministry of Health & Family Welfare as part of the Ayushman Bharat Digital Mission. It is an interface through which insurers, third-party administrators (TPAs), government scheme administrators, hospitals, laboratories, polyclinics, as well as beneficiaries can exchange information pertinent to claims.

How Will the National Health Claims Exchange (NHCX) Work?

The primary aim of the NHCX portal is to make it easier for hospitals and insurance companies to share information so that they can streamline their health insurance claim settlement processes. Bhaskar Banerjee, Chola MS General Insurance’s Executive Vice President of marketing, said: "In addition, NHCX would act like a hub where any participant in the healthcare ecosystem in India could connect with others seamlessly over data sharing".

Health Insurance Claim Settlement Through NHCX: What Will Change For Policyholders?

At present, while processing cashless claims, policyholders must present their health cards along with relevant forms and documents at the hospital facility. The hospital then manually fills up claim forms before scanning the documents and uploading them into various portals of different insurers or TPAs. This data is digitised on the insurer’s end, leaving room for manual authentication and adjudication. Then again, all these documents are sent back to the hospital by the insurer/TPA to have the insured patient discharged.

With the introduction of NHCX, most processes will be digitised and automated. This common claim format will prevail across both government and private health insurers, as identified by NHA. ‘The Ayushman Bharat Health Account (ABHA)’ number enables hospitals to access digitised insurer details.

The information is automatically validated by the NHCX portal before reaching the specified insurer. The insurer will then, digitally, verify and adjudicate the claim while the hospital discharges him/her.

Faster Health Insurance Claim Settlement

Recently, India's Insurance Regulatory and Development Authority (IRDAI) mandated that all cashless claims should be processed within three hours upon receipt of the request for discharge authorisation from the hospital. In case it exceeds 3 hours later any additional amount charged by the hospital shall be borne by the insurer out of the shareholder fund.

Similarly, “in case where such request is complete in all aspects, the decision shall be communicated to the service provider within one hour of receipt of such request,” said the regulator.

To health insurance policyholders, this NHCX platform guarantees a faster settlement process, which adds up to a shorter time in the hospital before getting discharged. Additionally, given that there may be fewer claims being made against each claim, this leads to lower per-claim processing costs for an insurance company. Furthermore, since operations become more transparent, frauds are expected to go down as well.

According to Shashank Avadhani, Co-Founder & CEO of Alyve Health, the National Health Claims Exchange (NHCX) launch will be a defining moment for India’s health insurance industry. NHCX will replace the tiresome and manual claim operations with smooth data transfer systems that are safe between providers and insurers. This would enable insurers offering customer-centric health platforms to settle claims instantly and offer total transparency to clients. On a larger scale, NHCX will curb fraud, thereby decreasing healthcare expenditure.

Benefits Of The National Health Claims Exchange

The NHCX platform offers a host of advantages. Read the pointers below to understand it better:-

Streamlined Process: The NHCX platform standardises the claim settlement process, making it simple for policyholders and insurers alike.
Faster Settlements: With faster processing times, patients are discharged from hospitals more quickly.
Cost Cutting: Automation and digitisation have led to lower operational costs for insurance companies.
Openness: Enhanced transparency mitigates risks of fraudulence, guaranteeing an equitable settlement process.
Interoperability: Facilitate seamless information exchange among different stakeholders in the healthcare ecosystem.

Conclusion

The introduction of the National Health Claims Exchange (NHCX) is a significant step forward in terms of fast, transparent and efficient claim settlements in the health insurance sector. Besides speeding up the claim process for policyholders, this platform can help cut costs for insurers as well as improve service quality. Once this new system has been adopted by the industry, it is expected that there will be a radical shift towards efficient handling of health insurance claims in India.

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Why Choose Jaagruk Bharat For Ayushman Vay Vadana Service Page?

At Jaagruk Bharat, we provide dedicated support for the Ayushman Vay Vadana service, helping elderly and policyholders navigate health schemes and claim processes. Here’s why you should choose our service:

Expert Guidance: Our team explains how to use your ABHA number, link your health plan, and claim via NHCX.
Claim Support: We assist you in preparing the right documents, tracking your claim, and liaising with insurers.
Awareness Building: We run webinars and publish easy-to-understand resources on how NHCX changes claims and discharge processes.
Consumer Advocacy: We help escalate issues if your claim is delayed, rejected, or incorrectly processed, protecting your rights.

Join our community today on the Jaagruk Bharat Ayushman Vay Vadana service page to stay informed, empowered, and ready to make the most of India’s digital health claim revolution.

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