Knowledge Centre

How Does Cashless Claims Work?

We often overlook one of the most important aspects of an insurance plan and i.e. a hassle-free claim. The conventional reimbursement process is where the policyholder submits documents for the incurred medical expenses after the treatment is completed.  That means the policyholder pays from his pocket at the time of the treatment. Also, if there is slight mistake or delay in the necessary paperwork submission, the claim might also get rejected.

The situation becomes all the more critical if you need to pay heavy amount upfront for an emergency or urgent surgery. In all such situations, health insurance with cashless facility comes as a blessing in disguise.

How Does Cashless Insurance Work?

Every health insurance company has a list of network hospitals across India where they offer cashless benefit. If you are seeking treatment in any of these hospitals, you can avail the cashless benefit. That is, the treatments for medical bills are directly paid by the insurance company to the hospital. You can check about network hospitals of an insurance company from their official website.

Steps to get cashless claims done smoothly

  • If there is a medical issue and you need to get admitted, check on the list of network hospitals in your vicinity and select one.

  • Every hospital has an insurance desk where they address insurance and cashless claim related queries. Ask them for a pre-authorization form. Alternatively, you can download and get a printout of the document from the TPA’s (Third Party Administrator) website.

  • Submit the filled form at the insurance desk. The TPA will process your form and send you a confirmation email along with a letter sanctioning the maximum treatment amount.

  • Third Party Administrator (TPA) is an IRDA licensed entity appointed by the Insurance Company to carry out policy and claims related facilitation services to the Insured on their behalf.

Benefits of Cashless Claims

  • Health insurance cashless plans come really handy if you need to arrange huge amount at short notice

  • No need to submit tons of paperwork for coverage claim. The claim process in case of a health insurance plan which is cashless is smooth and hassle-free

  • In case of cashless claims, insurance companies pay directly to the hospital. There is no waiting period for reimbursement

  • In case of emergency, you can get admitted without worrying about finances.

Cashless Health Insurance Plans by HDFC ERGO

HDFC ERGO has a huge network of 10,000+ hospitals across the length and breadth of India. That means when you buy HDFC ERGO my/Health Suraksha health insurance plan, you can avail cashless hospitalization and healthcare facilities. It is clearly one of the  best health insurance cashless plans and has the least documentation and settlement time as well as a hassle-free claim procedure.

So, get your health insurance plan with cashless facility today from HDFC ERGO and have peace of mind knowing that you are prepared for any eventuality.

Disclaimer: The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before going ahead with the sales.

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