Health Knowledge

Step-by-Step Procedure for Initiating a Cashless Health Insurance Claim

Having healthcare insurance can be a significant relief during times of medical emergencies or hospitalisation. One of the most convenient aspects of healthcare insurance is the cashless claim process, which provides a hassle-free way to handle medical bills. 

By opting for this option, individuals can avoid the tedious task of submitting reimbursement claims and experience a smoother, quicker, and more efficient process.

This is only possible if you clearly understand the health insurance claim process. Thus, this article will go through the detailed process, but before that, let us understand what cashless healthcare insurance is. 

What is a Cashless Healthcare Insurance? 

Cashless healthcare insurance is a type of health coverage that lets people receive medical treatment at certain hospitals and clinics without paying any upfront. This means that the insurance company directly covers the medical insurance plans expenses instead of paying themselves. 

This way, the insured person can concentrate on getting better without the immediate burden of paying medical bills.

Coverage Under Cashless Healthcare Insurance

Cashless Healthcare insurance offers various coverages. Some of them are:

1. Hospitalisation Expenses

It pays for the hospital stay, which includes room charges, medical tests, doctor’s fees etc. 

2. Day Care Procedures

It includes coverage for important medical treatments and surgeries that don’t need overnight stays, like chemotherapy and cataract surgery.

3. Ambulance Services

It takes care of ambulance costs during emergencies, so policyholders can get to the hospital quickly without worrying about the expenses.

4. Organ Transplantation

It provides coverage for the expenses related to organ transplant surgeries, including donor costs and aftercare, helping policyholders manage their treatment costs.

5. Alternative Treatments

Some cashless health policies cover alternative treatments like Ayurveda, Homeopathy, or Naturopathy, depending on the policy terms and conditions.

Benefits of Cashless Healthcare Insurance

Cashless Healthcare insurance has many advantages. Some of them are:

1. Emergency Support

Cashless insurance proves to be a lifesaver during unexpected medical situations. It allows policyholders to receive timely treatment without delay. 

2. Financial Security 

Having a cashless health plan gives policyholders and their family peace of mind during medical emergencies. This is because they do not have to worry about arranging money for treatment, so they can focus on getting better without stress.

3. No Claim Reimbursement Hassles

With a cashless health policy, policyholders must not undergo the cumbersome claim reimbursement process. This saves time and effort, provided the policy covers the treatment.

Steps-By-Step Claim Process of a Cashless Healthcare Insurance

A cashless health insurance claim is a straightforward process. You can follow the following steps:

Step 1: Choose Network Hospital

In case of a planned hospitalisation or treatment, the policyholder must select a hospital part of the insurance company’s network. 

Step 2: Inform the Insurance Company

Before getting admitted to the network hospital, inform the insurance company about the upcoming hospitalisation. They must provide the policy number, patient’s name, and hospital details. 

Step 3: Verify Eligibility

The insurance company will verify the policy’s coverage and the individual’s eligibility for the claim. They will also check if the proposed treatment is covered under the policy.

Step 4: Show Health policy Card

Upon admission to the network hospital, the policyholders should show their health plan card and a valid photo ID to the hospital’s insurance desk. They will initiate the cashless claim request with the insurance company.

Step 5: Approval Process

The insurance company reviews the claim request and communicates with the hospital to ensure all necessary information is provided. Once the approval is granted, the hospital will start the treatment.

Step 6: Hospitalisation and Treatment

The policyholder receives the required medical treatment without paying upfront. 

Step 7: Final Settlement

After the treatment, the hospital sends the final bill and medical reports to the insurance company. The insurer then settles the bills directly with the hospital, per the policy terms.

Step 8: Paying for Non-Covered Expenses

If the policy does not cover certain medical expenses, the policyholder needs to settle those expenses directly with the hospital. These expenses can include items excluded from the policy or exceeding coverage limits.


If you know the process, initiating a cashless health insurance claim is a simpler, straightforward process. Moreover, policyholders can access quality medical care without financial burden during medical emergencies.

So, if you want comprehensive and reliable cashless healthcare insurance coverage, consider exploring Niva Bupa, the best health insurance company. Their extensive network of hospitals and seamless cashless claim process can help policyholders access quality healthcare with a hassle-free experience. 

Visit their official website today to explore the range of insurance plans tailored to your needs. 

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