How Do I Avail Cashless Claim Settlement for My Elevate Health Insurance Policy?

Cashless claim settlement is available under the Elevate Health Insurance policy. This requires you to go for treatment at a network hospital and follow the insurer’s claim process. The insurer pays eligible medical expenses directly to the hospital. That cuts down on the need to pay upfront.

Keep reading to learn about this settlement.

What Is a Cashless Claim Settlement?

A cashless claim settlement allows the insurer to pay eligible hospital bills directly to a network hospital. The policyholder is not obliged to make an upfront payment for the total treatment amount.

Some expenses may not be covered by the policy. The insured person may still need to pay for non-medical items and other excluded expenses.

How Can You Check Whether a Hospital Is Eligible for Cashless Treatment?

Before going for treatment, it is important to check if the hospital is in the insurer’s network.

You can check this through the following steps:

• Checking the network hospital list on the insurer's website


• Contacting customer support for confirmation


• Asking the hospital's insurance desk for assistance

If you do not choose a hospital from the insurer’s network, your request for a cashless claim will be rejected.

How Can You Start a Cashless Claim During an Emergency Hospitalisation?

Medical emergencies can happen without warning. In such situations, the insured person should be admitted to a network hospital as soon as possible.

Once the patient is admitted, you can take the following steps:

• Share your policy details with the hospital so they can start the cashless claim request.


• Inform the insurer or TPA (Third-Party Administrator) at the earliest


• Provide any documents requested by the hospital


• Respond to any queries during claim verification

If the claim is approved, the insurer settles the eligible expenses directly with the hospital.

What Should You Do Before a Planned Hospitalisation?

If the hospitalisation is planned, inform the insurer or third-party administrator (TPA) in advance.

Also, you should follow these processes:

• Make sure the hospital is in the insurer’s network.


• Bring your health insurance card and identification.


• Complete the pre-authorisation form and forward it to the hospital.

If you complete these steps early, it can help you avoid delays during admission to the hospital.

How Does the Claim Approval Process Work?

Once the insurer receives the pre-authorisation request, it reviews the submitted information and policy details.

During this stage, the insurer may verify policy coverage and review medical records. They will also request additional information and assess eligibility under policy terms

If the request is approved, the hospital is informed, and eligible treatment expenses can be settled through the cashless facility.

What Documents May Be Required for the claim?

The insurance providers ask for a few documents to verify your cashless claim. Here are a few commonly requested documents:

• Health insurance card


• Photo identity proof


• Pre-authorisation form


• Medical records and reports


• Doctor's recommendations, if required

Providing complete and accurate documents can help speed up the approval process.

What Expenses May Not Be Covered Under a Cashless Claim?

Even when a cashless claim is approved, these expenses may not be included in some policies:

• Non-medical consumables


• Charges excluded under the policy


• Deductibles, if applicable


• Expenses exceeding policy limits

It is important to review the policy wording to understand the exact coverage available.

Cashless claim settlement can make hospitalisation easier by eliminating the need for large upfront payments. Always check the terms of the policy and the list of network hospitals before going for treatment.