Cashless Health Insurance Claim Process

Cashless Health Insurance Claim Process

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Cashless Health Insurance Claim Procedure | Health Insurance Cashless Claim Form | Health Insurance Cashless Claim in Hindi

Buying a health insurance policy is extremely important as due to the global pandemic many people have faced financial issues regarding hospitalization and treatment of the disease. In order to provide some financial support to the people for the high cost of treatment and to ensure quality treatment in private hospitals, health insurance providers have launched various types of health insurance policies. In today’s article, we will discuss about Cashless Health Insurance Claim.

Cashless Health Insurance Claim Process

 These policies are loaded with facilities and benefits like hospitalization charges, medicine cost, room rent, ambulance charges, health check-up etc. which can be availed by the policyholder at different times. Various types of claims can be made as per the choice of the customer to avail these benefits.

Health insurance is claimed in two ways:

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  1. Cashless
  • Planned
  • Emergency
  1. Reimbursements

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The policyholder can either make a cashless health insurance claim or they can go for the reimbursement claim settlement process. If you seek treatment at one of the network hospitals of the insurer then you are eligible to file for the Cashless Health Insurance Claim benefit under which the medical dues are settled directly by the insurer without any effort and hassle.

You can also go for treatment at the hospital of your choice and file a reimbursement claim under which you will have to pay the medical dues initially and later the amount will be transferred to your bank account. Depending on your financial budget and comfort, you can choose the most suitable type of claim settlement process for you.

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Claims Process for Emergency Treatment at the Cashless Network:

The cashless claims process for emergency treatment is as follows:

  • You have to notify your insurance company/third-party administrator within 24 hours of hospitalisation. Your Claim Intimation/Reference Number will be generated.
  • The hospital should fill in and submit your cashless claim form to your insurer.
  • An authorisation will be sent to the hospital by the insurance company on receiving your cashless claim form.
  • Your medical expenses will be paid by the insurance company. If your claim is rejected, you will receive a notification about the same on your email address and registered mobile number.

Health Insurance Cashless Claim Settlement Process

Cashless health insurance claim settlement is done at the health insurance provider’s network hospital. Under this type of claim, the medical dues are paid directly to the hospital by the insurer without involving you. It makes the entire claim settlement experience smooth, quick and hassle free as you do not have to pay a single penny out of your pocket.

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A health card is issued by the insurer to the policyholder which must be presented at the hospital desk to avail the cashless health insurance claim benefit. This type of claim settlement process covers all your hospitalization and medical expenses. To avail the cashless claim, you need to inform your insurer or TPA about the hospitalization at the earliest. Let us have a look at some of the key features of Cashless Health Insurance Claim benefits:

  • Covers both planned and unplanned hospitalization expenses.
  • No Claim Bonus is provided to the policyholder for not making a claim in the policy year.
  • This can be availed only in the network hospitals of the insurance provider.
  • Customers are also offered ambulance charges, daycare expenses, household expenses, free look period, etc.

How to make a cashless claim for a health insurance policy?

Follow the given steps to claim cashless health insurance in case of medical emergency:

  • In case of planned hospitalization, notify your insurer or TPA in advance, whereas in case of unplanned hospitalisation, inform your insurer or TPA at the earliest.
  • Get hospitalized at one of the health insurance company’s network hospitals.
  • Show your health card issued by the insurer at the hospital desk to avail the cashless claim benefit.
  • Fill the Cashless Claim Settlement Process form with all the required information and attach all the required documents with the form.
  • Submit the form at the hospital’s desk and the insurer will pay the medical dues directly with the hospital without involving you.

Cashless health insurance claim settlement process is less time consuming and pocket friendly as compared to any other type of claim process, as the policyholders do not have to pay anything out of their pocket. Any other necessary information regarding the claim process of the policy purchased by you can be read from the policy terms and conditions mentioned in the policy papers.

Conclusion

You can avail any type of claim settlement benefit based on your choice. In case of reimbursement claim, you will have to pay the medical dues out of your pocket and later the amount will be reimbursed to your account. Therefore, you must analyze your preferences and requirements before taking a decision in such matters relating to an insurance policy.

Disclaimer – Cashless Health Insurance Claim Article is issued in the interest of general public and is for general information purposes only. Readers are advised not to rely on the content of the article as conclusive in nature and do further research or consult an expert in this regard.

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Insurance in Hindi

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