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FAQs

Disclaimer - This article is issued in the general public interest and meant for general information purposes only. The views expressed in this blog are solely those of the writer and do not necessarily reflect the official policy or position of Canara HSBC Life Insurance Company Limited or any affiliated entity. We make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability, or availability with respect to the blog or the information, products, services, or related graphics contained in the blog for any purpose. Any reliance you place on such information is therefore strictly at your own risk. You should consult with a qualified professional regarding your specific circumstances before taking any action based on the content provided herein.

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FAQs

Disclaimer - This article is issued in the general public interest and meant for general information purposes only. The views expressed in this blog are solely those of the writer and do not necessarily reflect the official policy or position of Canara HSBC Life Insurance Company Limited or any affiliated entity. We make no representations or warranties of any kind, express or implied, about the completeness, accuracy, reliability, suitability, or availability with respect to the blog or the information, products, services, or related graphics contained in the blog for any purpose. Any reliance you place on such information is therefore strictly at your own risk. You should consult with a qualified professional regarding your specific circumstances before taking any action based on the content provided herein.

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Family Health Insurance Plan What is Health Insurance? Health Insurance For Parents Health Insurance Tax Benefit Under 80-D Health Insurance Facts Difference Between Life and Health Insurance

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Family Health Insurance Plan What is Health Insurance? Health Insurance For Parents Health Insurance Tax Benefit Under 80-D Health Insurance Facts Difference Between Life and Health Insurance

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When Should You Buy Health Insurance?

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When Should You Buy Health Insurance?

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Incurred Claim Ratio What is Copay in Health Insurance? What is Cashless Treatment? Accidental Cover in Saral Jeevan Bima Tips to Buy Health Insurance Short Term Health Insurance Plan

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Incurred Claim Ratio What is Copay in Health Insurance? What is Cashless Treatment? Accidental Cover in Saral Jeevan Bima Tips to Buy Health Insurance Short Term Health Insurance Plan

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Glossary

TPA: A licensed intermediary that manages cashless claim processing between the hospital and the insurer Co-payment: A fixed percentage of the hospital bill that the policyholder must pay out of pocket, even under cashless cover

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Glossary

Pre-authorisation: An approval process where the insurer reviews and approves a cashless treatment request. TPA: An intermediary between the insurer and hospital that facilitates claim processing and cashless approvals.

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Glossary

Pre-authorisation: An approval from the insurer for a planned treatment, confirming that it is covered under the policy

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Glossary

Pre-authorisation: An approval process where the insurer reviews and approves a cashless treatment request. TPA: An intermediary between the insurer and hospital that facilitates claim processing and cashless approvals.

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How Does a Cashless Mediclaim Policy Work?

Pre-Authorisation Request: The hospital submits a pre-authorisation form to the insurer or TPA, detailing the diagnosis, proposed treatment, and estimated costs. This is the trigger for the cashless process to begin.

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Steps to Claim Cashless Treatment in Tier-2 and Tier-3 City Hospitals

Get Pre-authorisation Approval - Once the hospital submits the pre-authorisation request, the insurer or TPA reviews it. For emergency cases, most insurers have a fast-track approval system, usually issuing a decision within a few hours. If the treatment is approved: You can go ahead with the treatment without worrying about upfront payment. The insurer will directly settle the bill with the hospital, subject to your health insurance plan limits. If additional details are required, the insurer might request more documents or medical reports, so be prepared to cooperate swiftly to avoid delays.

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How Does a Cashless Mediclaim Policy Work?

Inform the TPA/Insurance Desk: Every network hospital has a dedicated insurance or Third-Party Administrator (TPA) desk. Notify them of your intention to avail of cashless treatment and present your policy details and identity proof.

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Steps to Claim Cashless Treatment in Tier-2 and Tier-3 City Hospitals

Inform the Insurance Desk at the Hospital - Once at a network hospital, your first stop should be the insurance or TPA desk. For planned treatments, visit the desk 2–3 days prior to admission. In the case of a medical emergency, notify them immediately after reaching the hospital. The insurance coordinator will help you fill out a pre-authorisation form, which includes: Patient details. Policy number. Preliminary diagnosis. Expected treatment plan and cost estimate. This form is then sent to your insurer for approval.