How do I opt for a cashless claim facility?

In order to avail the cashless claim facility, the insured has to be treated in a hospital which is a part of the network of the insurer. At the time of hospital enrollment, you have to provide details of the health insurance policy and present the e-card or other physical proof of the health insurance plan.

You are eligible to avail cashless hospitalization and treatment, if the illness/injury is covered under the policy. All the medical bills are sent to the insurance provider by the hospital once the patient is discharged from the hospital. The insurance provider then calculates the expenses and settles the payment.

The claims process for treatment at a cashless network hospital depends upon the type of treatment which can be either Planned or Unplanned. Unplanned medical treatment at a cashless network hospital occurs at the time of an emergency.

Cashless Claim Process for Planned Treatment:
Here, the insured has to inform the insurance provider of the hospitalization or treatment requirement prior to availing cashless treatment. The company should be informed a couple of days before the treatment.

A cashless claim request form must be submitted to the insurance provider via email or post. If you have any query related to the cashless claim process then you can contact the customer care of your insurance provider. Once all the procedures have been processed then the insurer will notify the hospital regarding the policy cover and eligibility.

On the day of admission in the hospital, the policyholder has to provide their health insurance card and the confirmation letter. The medical bills will be paid by the insurer, directly to the hospital.

Cashless Claim Process for Unplanned (Emergency) Treatment:
During a medical emergency, the policyholder can contact the customer care service team of the insurer, to get information about the nearest affiliate hospital. You have to provide your health insurance card and avail cashless hospitalization. The hospital has to fill in the cashless claim request form and submit it to the insurer. You can even send the request form through customer care.

An Authorization Letter will then be issued by the insurance company to the hospital, indicating the policy coverage. The medical bills will be paid by the insurance company, directly to the hospital. In case of rejection of the claim, an email will be sent to you explaining the reasons for rejection.