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IndiaFirst Life Insurance adopts unique approach to cashless claim settlement

Buying a health insurance policy is very easy but when it comes to making a claim through a third-party administrator (TPA), policyholders have to undergo a tedious process.

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Last Updated - May 23, 2023
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Buying a health insurance policy is very easy but when it comes to making a claim through a third-party administrator (TPA), policyholders have to undergo a tedious process. IndiaFirst Life launched its first unit-linked health plan ‘IndiaFirst Money Back Health Plan’ which aims to address the claim settlement process in a unique way.

Normally, in order to make a claim, a policyholder has to either contact the TPA or the insurance company via telephone, email or fax. IndiaFirst Life is using a tech-savvy approach where-in the policyholder can get a cashless treatment simply by swiping their card at the hospital. The company is networked with 4,956 hospitals across the country for providing a cashless treatment.

Commenting on this, Dr. P Nandagopal, CEO and MD of IndiaFirst Life said, “The customer need not go to the TPA or send a fax. Once he swipes the card, the authorisation immediately happens. Again when he gets discharged from the hospital, he would need to swipe it and the hospital gets the money through the MasterCard service network, bypassing the entire documentation that is otherwise required and makes the whole process hassle-free.”

How does this work?

1. The policyholder will swipe his or her card at the same machine that is used to swipe a debit or a credit card

2. The information gets passed on to the TPA, who will contact the hospital and get details of the medical treatment that the patient needs to undergo

3. If everything is in place, the cashless claim gets approved and the insurance company directly pays the hospital

About IndiaFirst Money Back Health Plan:

This is a savings-cum-indemnity health plan with a policy term of 5 years for single pay and 10 years for regular pay. It offers a comprehensive health cover for the entire family along with the investment flexibility to grow wealth by investing in different funds under a single plan. The minimum sum assured for individuals is Rs 1.5 lakh whereas the maximum sum assured is Rs 5 lakh. The maximum sum assured for a family floater policy is Rs 10 lakh and the policyholder can include spouse, up to 2 children and parents. The cover can be extended to include new members in case of marriage or remarriage, child birth or legal adoption. In case of hospitalisation, surgery etc, the plan pays for the hospital bills. It also covers 195 listed day care procedures, cost of medicines, diagnostic tests, etc.

In case if the policyholder gets treatment at a non-networked hospital, then IndiaFirst Life will pay only 80% of expenses, while the remaining 20% will have to be borne by policyholder.

Just like most other health insurance policies, there is a waiting period of 4 years on pre-existing diseases. Since this is a unit-linked health plan, the policyholder has the option to choose from six-investment funds and make partial withdrawals after 5 complete policy years.

The new tech-savvy approach that IndiaFirst Life has adopted is bound to address the pain points of a policyholder, which is getting a hassle-free cashless settlement.

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