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Cashless Settlements is one of the prominent feature offered by several health insurance policies. Through this feature, health insurance policies work towards a cashless settlement for hospitalization bills.

There are two types of claim settlement in health insurances, the first one reimbursement which means repayment or payment at a later stage, and the second one cashless settlement.

Generally, people buying a health insurance policy, look for policies that offer the later claim settlement so that they would have not to fork out their own money to pay the hospital bills, and get paid later by the insurance company.

Well, to get the benefit of cashless settlement from your health insurance policy, it is important to follow a set of steps and processes for you to make the claim settlement smooth. Here below we are discussing the five key steps for an easy settlement.

Have a look at these!

First Step: Search For The Network Hospitals………

Every health insurance company has tie-ups with several hospitals all over the country. So before you buy a health insurance policy, it would be better to search and locate a network hospital impaneled with your insurer for cashless service.

You can easily find the network hospital through the insurer’s website.

Choose a hospital that is preferably near your residence, especially for planned hospitalization. If you select a networks hospital impaneled with your insurer then the insurer would directly settle the bill with the hospital.

That simply means you have to pay nothing or at best a small amount from your pocket, to clear the hospital bills.

Second Step: Inform The Insurer or TPA Before………

In case of planned hospitalization, do inform your insurer or the third-party agent about your treatment at least a week before you plan to get admitted to the hospital.

In that scenario, your insurer or the TPA will ask for relevant medical documents and doctor recommendations via email. Do send them, after that they will provide you with a consent letter for cashless settlement. Submit this letter at the hospital during your admission, for further process.

In case of an emergency admission, you must inform the insurer or TPA within 24 hours of getting the patient admitted.

Third Step: Do Read About Room Rent Capping In Your Policy……..

Most of the health insurance policies have limits on rents, and it varies. It could be Rs 5,000 per day, or a percentage of sum assured, usually 1 percent. So, if you get admitted to a hospital that charges a higher amount, you may have to pay the remaining sum from your pocket.

However, you can prevent this if you buy a policy that does not include room rent capping.

Fourth Step: Do Read About The Exclusions And Co-Pay Clauses……..

Some several charges and services may not be paid by the insurance company like they may not pay for disposables used during the treatment or they may not pay for registration or service charges.

These are the exclusions as per your health insurance policy and for these, you have to pay from your pocket.

Second, comes the co-pay clause, in which according to your insurer, you need to pay a portion of the bill and the rest will be paid by the insurance company.

So basically, you need to be aware of this amount and prepare yourself before.

Fifth Step: Do Carry Your Identity And Policy Proofs……..

You must carry the insurance card that your company would have issued, your policy document, your PAN, and Aadhaar cards for address and identity proof. These documents would be required to submit along with medical documents and diagnostic reports at the time of admission to the hospital.

You can contact your insurer or can visit Ashutosh Securities Pvt. Ltd. for any further assistance in mutual fund investment. Keep reading our article and stay updated with the latest news about Health Insurance and Life Insurance!

For any kind of query, you can contact us at Shri Ashutosh Securities Pvt Ltd., we are here to help you in any way possible.

Happy Investing!

(Mutual Fund investments are subject to market risk Illustrations are for example only, there is no guarantee of returns. Past performance is not an indicator/guarantee to future returns).