Health Insurance


#1

What is the procedure of cashless claim in health policy??
Also after making the claim , what is the turn around , in which the insurer has to disburse the claim.


#2

Hi Azizkhan,

The process for cashless claim will differ from one insurance company to another. However, we can tell you the generic procedure that most insurance companies follow. There are 2 kinds of hospitalisation – one is planned hospitalisation and the other is emergency hospitalisation. In case of planned hospitalisation, insurance firms require you to inform them well in advance if you are opting for a cashless claim. You need to fill a cashless request form that might be available on your insurance firm’s website. You might need to scan and attach relevant documents. Once you submit the form, the insurance company as well as the hospital (where you plan to go) will verify the claim. You might also need to fill a form at the hospital. Once you have your discharge summary and it is sent to the insurance company, the company will settle the claim with the hospital. Most insurance firms revert within a day or two if all documents are complete. In case of emergency hospitalisation, you will have to fill forms at the hospital and inform your insurance company’s customer care that you will be getting hospitalised. Most insurance firms either accept or reject your claim within 6-8 hours. Even though there are firms that claim that they can do it within 4 hours, it may take longer than that. Once you get your discharge summary, the insurance firm will settle the claim with the hospital.

Cheers,
BB Expert