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How To Make A Cashless Health Insurance Claim?

Updated On Jan 17, 2024

Buying a health insurance policy is of utmost importance as due to the global pandemic many people have faced financial issues regarding the hospitalization and treatment of the disease. To provide the people with some financial aid for the high costs of treatment and to ensure quality treatment at the private hospitals, the health insurance providers have rolled out health insurance policies of various types. These policies come packed with features and benefits like hospitalization expenses, medication costs, room rents, ambulance charges, healthcare checkups, etc. which can be availed by the policyholders at different points in time. To avail these benefits different types of claims can be made according to the choice of the customer.

The policyholder can either make cashless claims or they can go for a reimbursement claim settlement process. If you seek treatment at one of the network hospitals of the insurer then you are eligible to file for cashless claim benefits under which the medical dues are settled by the insurer directly without much effort and hassles. You can also seek treatment at a hospital of your choice and file reimbursement claims under which you have to clear the medical dues initially and later the amount will be transferred into your bank account. Based on your financial budget and comfort you can choose the most suitable type of claim settlement process for yourself.

How To Make A Cashless Health Insurance Claim?

About Health Insurance Cashless Claim Settlement Process

Cashless claim settlement for a health insurance policy is made at the network hospital of the health insurance provider. Under this type of claim, the medical dues are directly cleared by the insurer to the hospital without involving you. This makes the whole claim settlement experience smooth, quick, and hassle-free as you do not have to pay a penny from your pocket. A health card is issued by the insurer to the policyholder which must be produced at the hospital desk to seek cashless claim benefits. This type of claim settlement process covers all your hospitalization and medical expenses. To seek cashless claims, you must inform your insurer or TPA about the hospitalization as soon as possible. Let us look at some of the key features of the cashless claim benefits:

  • Covers both planned and unplanned hospitalization expenses.
  • No claim bonus is provided to the policyholder for not making claims in a policy year.
  • It can only be availed at the network hospitals of the insurance provider.
  • Ambulance charges, daycare expenses, domiciliary expenses, free look period, etc. are also offered to the customers.

How To Make A Cashless Claim For A Health Insurance Policy?

Follow the given steps to make a cashless claim at the time of a medical emergency:

  1. In case of planned hospitalization, inform your insurer or TPA in advance, while in case of unplanned hospitalization, inform your insurer or TPA as early as possible.
  2. Get hospitalized in one of the network hospitals of the health insurance company.
  3. Show your health card, issued by the insurer, at the hospital desk for availing cashless claim benefits.
  4. Fill out the cashless claim settlement process form with all the necessary information and attach all the necessary documents along with the form.
  5. Submit the form at the hospital desk and the medical dues will be cleared by the insurer directly with the hospital without involving you.

Cashless claim settlement processes take less time than any other type of claiming process and are pocket-friendly, as the policyholders do not have to pay anything from their pockets. Any other necessary information regarding the claim process of your purchased policy can be read from the policy terms and conditions mentioned in the policy papers.

Conclusion

You can avail any type of claim settlement benefits based on your choices. In case of a reimbursement claim, you have to pay the medical dues from your pocket and later the amount is reimbursed into your account. Therefore, you must analyze your choices and requirements before deciding on such cases related to the insurance policy.

Also Read:

Factors To Consider While Buying The Best Cashless Insurance Policies In India

How To Check Health Insurance Claim Status?

Disclaimer: This article is issued in the general public interest and is meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive and should research further or consult an expert in this regard.

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