Glossary · Insurance
Cashless Hospitalisation
A facility offered by health insurers where the insured does not pay cash to the hospital for covered treatments; the insurer settles the bill directly with the network hospital.
Cashless hospitalisation is available at hospitals in the insurer's network. The process requires pre-authorisation (except in emergencies) — the hospital sends a request with diagnosis and estimated cost to the insurer's TPA (Third Party Administrator), which approves within hours. The insured only pays non-covered items (like co-pays or excluded items) and the deductible. Cashless is more convenient than reimbursement and is the preferred mode for planned procedures.
Examples
A patient undergoes a planned knee surgery at a network hospital, gets pre-authorisation, and the insurer settles ₹3.5 lakh directly with the hospital — the patient pays only the deductible and exclusions.