A recent Policybazaar survey of 2,228 customers across metros and Tier-II and Tier-III cities revealed that cashless claims provide a better experience than reimbursement claims. According to the survey conducted between August 2024 and September 2025, customers who underwent hospitalisation or attended family members filed health insurance claims and reported their experiences. The findings highlight the operational advantages of cashless treatment over reimbursement processes.
Cashless claims offer several operational benefits that make them preferable for customers. As reported by Policybazaar, the insurer settles the hospital bill directly, eliminating the need for customers to pay out-of-pocket during hospitalisation. Cashless treatment is available at hospitals in the insurer's network that follow negotiated package rates and have dedicated insurance or third-party administrator (TPA) desks. According to Shilpa Arora, co-founder and chief operating officer of Insurance Samadhan, this coordination helps speed up authorisation and reduces documentation burden on customers. The cashless facility works exactly as designed, with the insurer paying the covered amount directly while customers settle only the non-covered portion.
Reimbursement claims become necessary when hospitals fall outside the insurer's cashless network, though this scenario is becoming less common as most insurers now have 15,000–20,000 hospitals in their cashless networks. As reported by Policybazaar, customers may also choose reputed hospitals without cashless tie-ups or face medical emergencies that force them to the nearest hospital. Amit Chhabra, chief business officer at Policybazaar, notes that cashless approval at discharge typically takes 3-4 hours, and some customers avoid waiting and file reimbursement claims later. However, customers must pay hospital bills upfront and submit complete documentation including bills, prescriptions, investigation reports, and discharge summaries.
Reimbursement claims face significant documentation challenges that can extend processing times. According to Policybazaar, customers must pay hospital bills upfront and submit complete documentation including bills, prescriptions, investigation reports, and discharge summaries. The insurer may scrutinise every bill line by line and seek additional medical records, with claims usually taking 7-10 days on average but potentially extending to the 30-day standard timeline. Amit Chhabra explains that reimbursement claims undergo more detailed review than cashless claims due to lack of standardised billing. However, IRDAI's 2024 health insurance rules require insurers to decide within set timeframes and provide clear discharge approval promptly, though timelines vary across insurers.
Industry experts emphasize the importance of proper documentation and timely submission to avoid reimbursement claims. Kapil Mehta, co-founder of SecureNow Insurance Broker, recommends applying for cashless approval at least 1-2 days before treatment for planned hospitalisation. Saurabh Vijayvergia, founder and CEO of CoverSure, advises customers to check hospital cashless status immediately before admission and submit complete documentation within the insurer's prescribed window of 15-30 days from discharge. The survey findings suggest that proper planning and timely coordination can significantly improve the health insurance claim experience for customers. However, customers should keep every bill, discharge summary, doctor's notes and reports, as reimbursement claims live or die on documentation.
