The introduction of cashless hospitalisation in insurance policies has helped people not to worry about cash while admitting their close ones in a hospital. With the help of this facility, patients can undergo any necessary treatment without the worry of direct payment.
In case of cashless claims, the insurer settles all bills (if it does not exceed a sum insured amount) directly through coordination with the hospital without involving the policyholder.
Wondering how cashless hospitalisation works in India? Here’s everything that you need to know about cashless hospitalisation.
In India, there are three types of cashless hospitalisation facilities available:
Under this particular insurance policy, only the insured person can seek cashless benefits on seeking treatment from a network hospital.
Individuals can cover themselves alongside their family members under a single health insurance policy. The cashless benefits are available to all the family members covered under this single plan.
This plan offers cashless benefits to senior citizen policyholders. The plan typically covers ambulance charges, hospital expenses, and various pre-existing ailments subject to policy terms and conditions.
The benefits of cashless hospitalisation are manifold. These include:
Download the Navi app and get yourself insured with a flexible EMI plan starting just from Rs. 241 per month!
Health Insurance providers have an association with various private and Government hospitals in India. These firms first check the quality of services offered by these hospitals and then negotiate on prices before tying up.
These hospitals are known as network hospitals. On getting admitted to one of these hospitals, the expenses incurred in due course of seeking treatment are directly settled by an insurer.
In this case, policyholders are aware of their hospitalisation in the upcoming days. In such a situation, follow the below-mentioned cashless hospitalisation process:
To claim this facility, follow these steps prior to the cashless hospitalisation process:
There are, however, a few facilities that are not covered under cashless healthcare plans. A few of these are as follows:
Cashless claims can sometimes get rejected, barring an insured person from seeking treatment. Following are a few instances wherein a cashless claim can get rejected:
However, there is a judgment from the Bombay High Court that TPAs will not reject or partially disallow claims. The onus lies entirely on the insurer. Previously, TPAs got paid incentives to deny any claim. But with this judgment, an insured will now get penalised with regards to claims.
There are a few pointers that you must remember before choosing any health plan. Check them below:
Check the sum insured amount before buying cashless health insurance. A policyholder must pay any excess amount of expenses breaching the limit.
Recently, various health insurance providers have come up with cashless claim facilities in OPD as well. This means an insured will not have to get hospitalised for 24 hours to avail of cashless claims.
A cashless hospitalisation facility saves a lot of hassle for an insured or his/her family members during medical treatments. The claims get settled directly between an insurer and the hospital. It makes the claim process smooth. Finally, people must read about inclusions and exclusions carefully before proceeding to purchase any health insurance.
With Navi Health Insurance, you can get cashless claims within 20 minutes across 10,000+ cashless network hospitals. With Navi, you can enjoy a claim settlement ratio of 97% for cashless claims.
Ans: A cashless claim is better than reimbursement as it offers peace of mind to policyholders and their families. In a cashless process, your insurer will settle your claim with the hospital directly. While in reimbursement, you pay out your expenses during an event and get it reimbursed later.
Ans: TPA is a third-party entity that administers your health insurance policy and initiates the claim process and employee benefits for another company. These firms offer underwriting services and customer service within the insurance industry.
Ans: A cashless plan is valid for 1 year in most cases. Few other insurers offer a plan with a validity of up to 2 years.
How about an affordable health insurance policy 👨⚕️ starting at a monthly premium of just ₹235? Install the Navi app now and get your policy in under 2 minutes.
Disclaimer: This article has been prepared on the basis of internal data, publicly available information and other sources believed to be reliable. The information contained in this article is for general purposes only and not a complete disclosure of every material fact. It should not be construed as investment advice to any party. The article does not warrant the completeness or accuracy of the information, and disclaims all liabilities, losses and damages arising out of the use of this information. Readers shall be fully liable/responsible for any decision taken on the basis of this article.
|Karunya Health Scheme||Niramaya Health Insurance Scheme||Best Health Insurance Repositories|
|Pradhan Mantri Suraksha Bima Yojana||Best Personal Accident Insurance Plans||Best Insurance Policy For New Born Baby|
|Third Party Administrator (TPA)||What is Super Top Up Health Insurance Plan||Deen Dayal Swasthya Seva Yojana (DDSY)|
|Best Health Insurance Plan For Parents||Incurred Claim Ratio In Health Insurance||Chief Minister Comprehensive Health Insurance Scheme|
|Best Health Insurance Policies In India||Best Health Insurance Policies In India||Best Family Floater Health Insurance Plans in India|
|No Claim Bonus in Health Insurance||IRDAI Guidelines For Health Insurance||OPD Cover in Health Insurance|
|Maternity Health Insurance Plans||Health Insurance Plans For Senior Citizens||What is Portability Of Health Insurance|
TPA in Health Insurance – Meaning, Full Form, Functions and RolesTPA (full form - Third Party Administrator) is a licensed intermediary between health insurance pol... Read More »
5 Best Cancer Insurance Policy in India 2023 – Types and BenefitsCancer insurance plans can give individuals and families financial protection from expensive cancer... Read More »
10 Best Cashless Health Insurance Policy in India 2023 – Taxation and CoverCashless health insurance plans are policies that provide medical coverage to policyholders without... Read More »
6 Best Critical Illness Insurance Companies in India 2023Critical illness insurance is a type of health insurance policy that protects against fatal illness... Read More »
10 Best Personal Accident Insurance Policy in India 2023Accident insurance plans provide financial assistance to the policyholder in the event of an unfort... Read More »
Best Health Insurance for Parents in India 2023 and How to Buy?Health insurance for parents offer several perks, including a higher insured sum and full coverage ... Read More »
Best Dental Insurance Plans in India 2023: Benefits, Types and How to Claim?Dental insurance plans are policies that provide cover for expenses arising out of standard dental ... Read More »
7 Best Health Insurance for Newborn in India 2023 – Benefits and CoverHealth insurance for newborns are crucial in today’s time. When you are a new parent, the safety ... Read More »
Yeshasvini Health Insurance Scheme: Apply for Yeshasvini Health Card OnlineEveryone should have access to quality, affordable healthcare. Yeshasvini Health Insurance Scheme i... Read More »
5 Best Diabetes Health Insurance in India 2023 – Top Plans, Cover and Benefits OfferedDiabetes Health Insurance plans are specifically designed insurance covers for people who have diab... Read More »
Best Family Floater Health Insurance Plans in India (2023)A family floater health insurance plan covers the medical expenses of the entire family. It is more... Read More »
10 Best Cashless Network Hospitals in India 2023 – Benefits and Claim ProcessCashless Network hospitals are accredited hospitals that have partnered with a health insurance com... Read More »
Top 10 Chit Fund Schemes in India in 2023Chit funds are one of the most popular return-generating saving schemes in India. It is a financial... Read More »
10 Best Gold ETFs in India to Invest in April 2023Gold ETFs or Gold Exchange Traded Funds are passively managed funds that track the price of physica... Read More »
10 Best Demat Accounts in India for Beginners in 2023Creation of Demat accounts revolutionised the way trades were conducted at the stock exchanges. It... Read More »
20 Best Index Funds to Invest in India in April 2023What is an Index Fund? An index fund is a type of mutual fund or exchange-traded fund (ETF) that... Read More »
Best Arbitrage Mutual Funds to Invest in India in April 2023Arbitrage funds are hybrid mutual fund schemes that aim to make low-risk profits by buying and sell... Read More »
10 Best SIP Plans in India to Invest in April 2023What is SIP? SIP or Systematic Investment Plan is a method of investing a fixed amount in ... Read More »
10 Best Corporate Bond Funds in India to Invest in April 2023Corporate bond funds are debt funds that invest at least 80% of the investment corpus in companies ... Read More »
10 Best Bank for Savings Account in India [Highest Interest Rate 2023]Savings account is a type of financial instrument offered by several banks. It lets you safely depo... Read More »