A Guide to Health Insurance and Cashless Hospitalization

Overview

Frequently Asked Questions

A facility where the insurance company settles the hospital bills directly with the network hospital, meaning the patient does not have to pay cash upfront.
A hospital that has an agreement with an insurance company or Third Party Administrator (TPA) to provide cashless medical treatment to its policyholders.
A clause stating that the policyholder must pay a fixed percentage (e.g. 10% or 20%) of the total hospital bill, while the insurer pays the remaining amount.
Rejections occur due to non-disclosure of pre-existing diseases, treatment at a non-network hospital, or applying for treatments excluded from the policy.
The initial time frame (usually 2 to 4 years) from the policy start date during which any health condition you had before buying the card is not covered.
It means the policy covers any room type (private, shared, ICU) without capping. Policies with room rent limits (e.g., 1% of sum assured) charge you extra for superior rooms.
A feature that automatically refills your complete sum assured amount if it gets exhausted during the policy year for a different illness.
Yes, premiums paid for yourself, family, and parents qualify for tax deductions under Section 80D up to ₹25,000 (or ₹50,000 if parents are senior citizens).
An external agency licensed by IRDAI that coordinates between the insurance company, the hospital, and the policyholder to process claims.
A 15-day grace period from the date you receive your physical policy document during which you can cancel the policy for a full refund if you dislike the terms.

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