A group health insurance policy provides coverage for your employees under a single plan. Employers can choose the policy terms as per the size and needs of their organisation. For most members of the group health insurance, a key benefit is cashless facility. In the absence of this facility, the insured employee will need to cover all hospitalisation bills and expenses on medicines in case of a medical emergency, and then file a claim from the insurer for a reimbursement for the expenses. With a cashless facility, the insured does not need to arrange for funds. Instead, the bills are settled directly between the hospital and the insurer. As far as the insured person is concerned, the treatment is “cashless.”
Is Cashless Facility Available Across India?
The good news is that cashless facilities are available across India. However, cashless claim settlement is available at network hospitals or hospitals with which the insurance provider has a tie-up. Leading insurance providers typically have a range of medical facilities across India included in their network hospitals.
Benefits of Cashless Claim Settlement Under Group Health Insurance
Opting for cashless claim settlement in group health insurance has several benefits for employers.
It helps attract talented employees from across India to your organisation and increases retention.
The sense of employee well-being boosts productivity.
Employees will not feel drained of funds during a medical emergency. to meet any expenses.
Employees can avail better medical facilities.
The premiums paid are tax exempted under Section 80C of the Income Tax Act, 1961.
PAN India cashless facility is particularly helpful for remote teams and when employees are travelling.
Things to Know About Cashless Facility Across India
Cashless claims settlement was available in 49% of hospitals across India, as of October 2023. Here are a few things to keep in mind:
Although the insurer pays the bills to network hospitals, this is limited to the sum assured under the group health insurance policy.
In case of planned hospitalisation, employees must inform the insurance provider at least two days in advance.
For medical emergencies, the insurance provider must be informed within 24 hours.
There is usually a co-payment clause even for cashless claim settlement. This means the policyholder may need to pay a certain portion of the bill, while the rest is paid by the insurer.
Exclusions to group health insurance and cashless facility across India typically include self-inflicted injuries, injuries from suicide attempts, cosmetic surgeries, illnesses traced to the misuse of drugs or alcohol, and abortion.
Ensure your employees understand that there is a waiting period. This is the time between the start of the policy and when they can claim benefits.
Pan India cashless facility eases the financial burden during a medical emergency. Most importantly, it ensures that the insured person has a stress-free period of recovery during medical treatment or hospitalisation. With network hospitals across India, cashless facilities can allow employees to focus on their recovery smoothly rather than worry about arranging for funds.
