Health Insurance: What is the procedure for availing cashless facility?

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NEW DELHI : What is the procedure to avail cashless facility? Is cashless better than reimbursement?

– Radhika

Yes, cashless claims settlement is considered hassle-free. It is a service provided by an insurer in its set of network hospitals through its TPAs (third-party administrators). In this, the insurance company directly pays the cost incurred for the treatment to a network hospital in accordance with the policy terms and conditions. Insurers provide a list of partnered network hospitals the policyholders. There is no need for a policyholder to pay hospital bills if they receive treatment at any of the network hospitals. The insurer directly settles the bill with the hospital. However, if you opt for treatment at a non-network hospital, then claims have to be settled through reimbursement.

For a completely healthy 27 year old bachelor, what is the right amount of health insurance as in coverage wise? I already have corporate insurance of 3 lakh.

– Mathews

Considering uncertainty, rising medical bills and hospitalisation costs, especially in the case of critical illnesses, it is advisable to buy a personal comprehensive insurance plan. So, as per affordability, the maximum coverage you could take, the better. However, a minimum of 5 lakh sum insured is a must have over and above your corporate insurance policy, or else you will end up paying the hefty hospital bills all by yourself. Also, personal health insurance policy provides you with an option to choose a policy as per your requirements and without any sub-limits, capping and co-payments.

(Queries answered by Sanjiv Bajaj, Joint Chairman and MD, Bajaj Capital. Please send queries and views to [email protected])

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