CASHLESS EVERYWHERE
We are glad to inform all our customers that in yet another effort to provide better access under our
Health Insurance Policy, we are launching Cashless Everywhere.
Right now, Cashless Facility is being offered only to the Hospitals in our Company’s Network.
However, henceforth, we shall extend Cashless Facility to even those Hospitals that are not in the
Company’s Network.
The provision of Cashless Facility to Hospitals outside the Company’s Network is subject to the
following conditions:
- For Planned Admission, the Company should receive the Intimation about the Planned
Admission at least 72 hours prior to the proposed date of admission. The insured
person/insured person’s representative shall notify the TPA (if claim is processed by
TPA)/company (if claim is processed by the company) in writing by letter, e-mail, fax providing
all relevant information relating to claim including plan of treatment, policy number etc. - For Emergency Admission, the Company should receive the Request for Cashless Facility in the
Prescribed Form at least within 24 hours after the time of admission. The insured
person/insured person’s representative shall notify the TPA (if claim is processed by
TPA)/company (if claim is processed by the company) in writing by letter, e-mail, fax providing
all relevant information relating to claim including plan of treatment, policy number etc. - The Hospital where the treatment is to be taken should meet the terms/conditions of the
Policy and fulfil the definition of ‘Hospital’ as laid down in our policy. The final decision to
extend cashless to a particular hospital will rest with the insurance company. - Cashless Facility would be available only if the treatment is found admissible under the
terms/conditions of the Policy. - The Request for Cashless Facility should be completed and signed by the Insured Person and
the Hospital and submitted with all the requisite documents including a copy of the Insured
Person’s Identification. - The Request for Cashless Facility should be sent to the TPA in writing by letter, e-mail, fax
providing all relevant information relating to claim including plan of treatment, policy number
etc. - Hospitals which are not in the Company’s Network should provide a Letter of Consent to
extend Cashless Facility. - Company reserves the right to reject the request for Cashless Facility. If Cashless facility is
denied, the Customer may submit the papers on completion of treatment, and admissibility
of the claim would be subject to the terms/conditions of the Policy.
This excerpt is from a PSU company’s website.