Know the ways to make a health insurance claim.

Unforeseen medical emergencies can occur at any time, and when they do, they can have a significant impact on your finances; you may suffer from a severe financial crunch. The most prudent way to face such situations is to have a suitable health Insurance cover that helps you get financial protection against medical expenses.

A health insurance policy gives you the assurance that you and your family can always avail of best quality treatment without worrying about the cost. If you ignore it, you may face the risk of depleting all your savings. This is because the treatment cost of some illnesses like cancer can run into several lakhs.

To claim compensation from the insurance company, you must be aware of the claim settlement processes, and file your request correctly to avoid delay in the settlement process. Typically, most insurance companies in India offer two types of claim settlement for health insurance – Cashless and Reimbursement.

What is a cashless health insurance claim?

If you have a cashless health insurance policy, you need not pay for any medical services you avail at the hospital. Once you get discharged, you must submit the bills, prescriptions, and other hospital-related documents to the insurer or the TPA (Third Party Administrator) appointed by your insurance company.

After the insurer or TPA reviews the bills, they will directly settle the bill with the hospital. However, the only condition to avail cashless treatment benefit is that you must seek treatment from a hospital that is part of the insurer’s network.

Benefits of cashless health insurance

Over the past few years, the demand for cashless health insurance is growing steadily as it offer many benefits, including:

• During a medical emergency, cashless health insurance helps you get best medical treatment, even if you cannot arrange cash immediately or are facing financial crunch.

• Cashless health insurance is specifically designed in a way that it helps policyholders do away with any kind of cash payments.

Steps for filing cashless health insurance claim

• Step 1

In case of a planned hospitalisation, you must take a pre-authorisation letter from the insurance company by informing them about the claim at least 48 hours before admission. In case of an unplanned or emergency hospitalisation, you must inform the insurer about the claim within 24 hours after admission.

• Step 2

Once you inform the insurer, and submit the cashless claim form, the insurer will send a confirmation letter.

• Step 3

Submit the confirmation letter and health card at the time of the admission and avail of the cashless facility.

• Step 4

After discharge, submit the bills and other documents as mentioned in the policy papers to validate your claim amount. The insurer will verify the claim, and settle the bills directly with the hospital.

Please note:

The steps mentioned above may vary from insurer to insurer.

Documents required to claim health insurance

Whether you file a cashless claim or reimbursement claim, you must submit certain documents to the insurer. The documents required may vary from one insurer to another but most insurance companies would require you to submit following papers:

• Duly filled and signed claim form

• Health Card

• Discharge card or discharge summary from the hospital

• Original bills and receipts

• Doctor investigation reports

• Prescriptions and bills

• Medical certificate/form signed by the hospital authority/doctor

Cashless health insurance or cashless claim benefit in health insurance policy allows you to avoid the hassles of arranging funds during a medical emergency. We at Kotak General Insurance offer cashless facility with our health insurance plans. So, take advantage of this and buy the best insurance cover to suit your family’s healthcare needs.

Kotak Health Insurance Cashless Claim Process for Un-Planned Hospitalization