Unforeseen medical expenses can be quite draining and can put you in financial jeopardy. To pay your hospital bills one doesn’t always have ready cash at hand. This is where cashless claims come to your rescue. Every insurer has a list of network hospitals across India where they offer cashless claims benefits. If the insured seeks treatment at any of the network hospitals approved by their insurer then he/she can receive the treatment without cost; meaning the insurance company will take care of your hospital bills directly without asking you to pay anything.
The claims process for treatment at a network hospital differs as per the kind of treatment - planned treatment and emergency treatment.
The cashless claims process for planned treatment:
Step 1: Choose a medical facility from the list of network hospitals
Step 2: Submit the pre-authorisation form to your insurer at the Third-Party Administration (TPA) counter at least several days before the treatment
Step 3: The insurance company will inform your hospital post form received
Step 4: The insurance company will send you a confirmation letter with a validity of 7 days from the issuance date
Step 5: Submit the health card and confirmation letter before admission. Your expenses will be paid by the insurer.
Cashless claims process for emergency treatment:
Step 1: Notify your insurer/third-party administrator within 24 hours of hospitalisation. Your claim intimation/reference number will be generated
Step 2: The hospital will fill in and submit your cashless claims form to your insurer
Step 3: The insurer will send an authorisation letter to the hospital on receiving the form
Step 4: Your medical expenses will be paid by your insurer or if rejected, you will be notified of the same via email or text
Documents required for the cashless claims process
Health card
Properly filled out and signed claim form
Medical form/certificate signed by the treating physician
Discharge summary or card (original) availed from the hospital
All bills and receipts (original)
Prescription and cash memos from pharmacies/hospital
Investigation report
In case of an accident scenario, then the FIR or Medico Legal Certificate (MLC) is required
Having the correct information at hand is crucial when filing an insurance claim. Read every line carefully and know your insurance policy thoroughly. When filing a claim be diligent with the information you provide. Timing is important so submit your pre-authorisation form to your insurer at your earliest. Keep your insurer details handy. The cashless claim process comes to your rescue at times of medical emergency and saves you the bother of arranging for money.
