Cashless Everywhere – What And How?

The awareness of opting for adequate health insurance cover is quite low in our country. The top two reasons for the same could be as follows –

**> Lesser number of insurance advisors than required for a hugely populated country like ours.

**> Limited scope of cashless hospitalization and complicated process of claim settlement. The good news is that the second reason may soon be a thing of past! ** Read on.

At present around 37% of health insurance policyholders have to go for ‘Pay first – Claim later’ or in other words – claim settlement through reimbursement procedure, in cases of claiming expenses incurred due to hospitalization. This happens in case of unplanned hospitalization or when policyholder gets treated in a hospital which is outside the network of the insurer.

This process is time-taking and complicated to say the least. Also, this reimbursement process makes the whole purpose of taking health insurance cover at the first place meaningless – at least to some extent as you have to maintain a sufficient amount of liquid balance to shell out in case of emergency hospitalization.

This ordeal is coming to an end. Policyholders will now be able to approach any hospital and avail of the cashless facility for their medical expenses, irrespective of whether the hospital is part of their insurers' cashless network or not.

General and health insurance companies, through the General Insurance Council, have come together to enable ‘Cashless Everywhere’ under which you can get admitted across any of the almost 40,000 hospitals in the country (hospitals registered under the Clinical Establishments Act, 2010, with a capacity of at least 15 beds) and still get entitled for cashless treatment – provided the following conditions are met –

**> For elective procedures, the customer should intimate the Insurance Company at least 48 hours prior to the admission.

**> For emergency treatment, the customer should intimate the Insurance Company within 48 hours of admission. **

> The claim should be admissible as per the terms of the policy and the cashless facility should be admissible as per the operating guidelines of the Insurance Company.

More specific details regarding this facility are expected to come from the insurer’s side soon. It is therefore recommended that check with your insurer for finer details regarding the same. We are keeping an eye on the ongoing developments and will try to keep you posted here with follow-up blog posts.