With the many of the survey it is proved that
purchase of medical insurance can keep you healthy for a long time. Health
insurance may be one of the most important purchases of your life. Health
policy essentially covers your medical expenses. Like other insurance policies,
Mediclaim Policy is a contract between the insurer and the individual/groups.
Anyone can buy medical insurance for individual or for all family members as
per the need. But before buying medical Insurance Policy one should understand
the following claim processes.
There are two possible ways for making Health
Insurance Claim:
1. Cashless Bases
2. Reimbursement Claim
1. Cashless Bases
2. Reimbursement Claim
Cashless
Facility: - In cashless hospitalization schemes,
Insurer pays directly to the hospital for your treatment. For Health-Insurance
Claim on cashless bases, your treatment must be at network hospital. You do not
have to pay bill with the hospital. The Insurance Company represented by the
TPA, co-ordinates with the hospital and pays the bills.
Network Hospitals- Companies tie-ups with hospitals after checking the medical facilities and negotiating the rates, these hospitals are called network hospitals. Cashless Health Insurance Facility available only in network hospitals.
TPA (Third party Administrator licensed by the
Insurance Regulatory and Development Authority (IRDA) ) - An organization that
ensure better services to policyholders. It is a middle layer between the insurers
and insured and provides cash less services at the time of hospitalization.
Reimbursement
Claim: - Reimbursement is process of compensating
someone for an expense. In reimbursement Mediclaim plan, the patient can be
admitted to the any hospital. Money spent on the treatment paid by individual
at that time, which can be further compensated by the insurance company as per
the terms and conditions. For claiming a reimbursement, document related with
the treatment like bills etc. have to produce in original while filling a
claim. Following are the four common documents which have to be in original while
filling Health Insurance Reimbursement-
* Hospital Bills.
* Discharge Slip of Hospital.
* Doctor's prescriptions.
* Diagnosis Reports.
* Discharge Slip of Hospital.
* Doctor's prescriptions.
* Diagnosis Reports.
Both Cashless and Reimbursement policies are
very much common now these days, You can choose any one as per your need. But
before buying any Health Insurance Policy must aware of the terms and
conditions of the insurance provider.
Bajaj Capital Insurance provides you a
comprehensive on-line insurance platform to compare and buy best insurance
policies offered by leading insurance companies in India.
To know more about health Insurance and get a free insurance quote call
1860-266-1226, we will happy to assist you. For more information you can also
log on to www.bajajcapitalinsurance.com.
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