Basic understanding of Cashless mediclaim policy

Posted by gagan sharma on March 8th, 2016

Health insurance policies widely known as mediclaim policy are the contracts which offer the insured of preferably cashless treatment in a hospital of his choice upto the extent of the sum insured in lieu of a specific premium which is paid in the very beginning.

For eg. A person pays a premium of X amount per year and is covered for Y amount every year. In an event of him falling ill or meeting with an accident and being admitted for 24 hrs or more (less then 24 hrs admittance is acceptable in case of going for listed day care suregeries) he can avail of a cashless treatment of any amount less than Y. The bills after proper approval are directly settled by the insurance company or through a TPA (third party administrator). The condition to avail cashless facility remains to be that the hospital should be in the network of the insurer.

Usually cashless mediclaim service is required in two situations of Planned Hospitalization and Emergency Hospitalization. A Planned Hospitalization is when one is aware of the hospitalization 2-3 days in advance indeed via consulting his/her doctor whereas an Emergency Hospitalization is when there is an emergency for immediate admittance of the patient such as accident or grave illness.

Tips for planned or emergency hospitalization

1.Mental solace is one big thing for a patient thus in case of planned hospitalization one should at first place decide upon the hospital which he/she trusts the most and should inform his/her TPA  or the insurer. However in case of emergency hospitalization since the hospital usually is the nearest accessible one; the choice of hospital doesn’t stand there thus a friend or relative should do the part of informing the TPA or insurer for a speedy and easy approval.

2.The Identification proof of the patient should be handy since it might be required at the time of applying for cashless facility.

3.If possible the relevant medical history and documents pertaining to the illness of the patient should be there as they help a lot in processing the things as well help the doctors in reaching to a result and treating the patient.

4.Insurance works on the law of Utmost Good Faith and that makes it such that whatever the insured says about him and situations is deemed true by the insurer. However if any sort of discrepancy is found in the details the claim can be cancelled as well. Thus always offer the material facts about yourself and situation to get a speedy approval for claim.

In any and evey case a mediclaim is a boon to the commoners as it looks after and provides for  the bitter most events in ones life. The peril is inevitable and emotional loss can’t be covered up but being prepared is the best for covering up the financial emergency atleast.

Cashless Bima

Address: Vishal Chamber, 516, 5th Floor, Sector-18

Noida U.P - 201301 (INDIA)

Customer Support: +91 9711116322.

Web - http://cashlessbima.com/