What is cashless claim and reimbursement claim?
Cashless claim: “Cashless claim” means when insured gets hospitalized in a network hospital/nursing home, he or she, need not have to pay for the covered medical expenses, with the hospital/nursing home, up to the sum insured specified under the Policy, provided the claim is intimated and Insurance company has approved the request as per the terms and condition of the Policy. The Insurance Company, co-ordinates with the hospital/nursing home directly and settles the bill after the discharge of the patient. All non –medical expenses and/or co-payment or medical expenses over and above the sum insured has to be borne by insured at the time of discharge from hospital.
Reimbursement claim: “Reimbursement claim” means, insured gets hospitalized in any of the hospital/nursing home within India, which meets the hospital criteria as mentioned in the Policy, pays the medical expenses at the time of discharge and lodge the claim with insurance company for the amount due under the Policy. Insurance company would process the claim as per the terms of the Policy and reimburses the covered medical expenses to insured if the claim is admissible.