Everything You Need to Know About Cashless Claims in Medical Insurance

Cashless claim is when hospital bills are settled by the insurance company. The policyholder does not have to make out-of-the-pocket expenses. It is paperless and hassle-free. Just make sure it is a ‘network hospital’ to receive the benefit. You can check the list from the official website of your health insurance company. This is quite useful during a contingency situation when you are cash-strapped without upfront money available. Top insurance companies like ManipalCigna offers the facility at 6500+ hospitals in India. Pick the sum insured as per your needs and preferences for quick approval.

You can make both planned claims and emergency claims. The best part is that there is no maximum entry age limit to any plan. The eligibility criteria are simple too. But it is a good idea to have a detailed knowledge of how it works. It will let you make an informed request.

Steps to Make a Cashless Claim

It is available after being treated for a disease or opting for a medical procedure. The entire cost of hospitalization will be cleared by the insurance company. But you might have to pay for a few bills which are excluded from the policy. Further, read the terms and conditions of the cashless health insurance carefully before going ahead.

Fill out the pre-authorization form submitted by the TPA counter during admission. Make sure to inform your provider since this will be sent to them for examination. Documents like KYC copies can be retained for verification purposes. The TPA might send you a confirmation mail and an idea of the maximum treatment amount. The claims will be settled as soon as the approval is received. Keep copies of medical reports, discharge bills, medical bills, and psychological test slips with you. These might be required for future references. Try to avoid mistakes. It can get the forms rejected.

Planned Claim

This is ideal when you know a hospitalization is to be done within the next 2-3 days. You can consider filling out the form and send to the insurer. This way you can save time. The authority will either approve the dismiss the claim. You also get notified regarding the eligibility and cover which makes it easy to arrange for extra funds, if needed.

Emergency Claim

Cashless treatment can be opted for grave illnesses and accidents. Ask your friends or family to send an email about the ongoing treatment as early as possible. The insurer will process the claim within the next 6 hours, if not less. This is quite a relief amid a crisis and helps you receive the best treatment without compromising on health.

The other options are cashless family health insurance and cashless health insurance for senior citizens. These cover various expenses like ambulance, hospitalization, and pre-existing illnesses. Submit the required documents and carry original ID proof at the time of hospital admission. Give complete information to speed up the process.

Benefits of Cashless Claims

There are plenty of good reasons to pick a cashless claim with a trusted insurance provider. It comes handy when you are unable to arrange a huge amount within a short notice. This can be especially quite helpful for young adults. The other benefits are:

• There is no waiting period and covers even while travelling.
• No hefty paperwork or time-consuming formalities.
• Do not have to dip into your savings or break your FD.
• No need to borrow money from relatives.
• Reduces financial burden and helps you get admitted at any time worry-free.
• Offers much-needed peace of mind to the policyholder and their loved ones.

A cashless treatment is a blessing in disguise. But it can be rejected for a number of reasons like the exclusion of a specific illness, expiry of the sum insured or delay in informing. Keep these in mind for a comfortable experience.

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