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Health insurance claims no longer require paperwork marathons. With apps like Policybazaar and Niva Bupa, you can manage everything from your phone — from finding a cashless hospital to tracking your claim in real time.
What Is a Cashless Claim?
A cashless claim means you don’t pay the hospital bill out of pocket. Instead, your insurer settles the bill directly with the hospital, provided it’s part of their network. Your job is simply to notify the insurer and get the treatment approved.
Before You Need It: Set Up Your App
Download and install either the Policybazaar app or the Niva Bupa Health app (formerly Max Bupa) from the App Store or Google Play Store. Log in using your registered mobile number or policy number. Complete your profile and link your health policy. Save your digital insurance card, available under “My Policies” or “E-Card” in both apps. This card acts as your ID at the hospital.
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Step 1: Find a Cashless Network Hospital Nearby
Open the app and go to the Hospital Locator or Find Network Hospital section. Enter your city, PIN code, or allow location access. Filter by speciality if needed — for example, cardiology or orthopaedics. Call the hospital’s insurance desk in advance to confirm they accept your specific insurer and plan.
In the Niva Bupa app, the hospital finder also shows bed availability and pre-authorization turnaround times at select hospitals.
Step 2: Inform Your Insurer Before Admission
For planned hospitalisation, notify your insurer at least 48 to 72 hours in advance. For emergency admission, notify within 24 hours of being admitted.
- On the Policybazaar app: go to Claims > Intimate a Claim > fill in admission details.
- On the Niva Bupa app: tap Claims > Cashless Hospitalisation > raise a new request.
You will need the following information:
- Patient’s name and policy number
- Hospital name and treating doctor’s name
- Diagnosis or reason for admission
- Expected date of admission
Step 3: Hospital Submits Pre-Authorisation Request
Once you inform the insurer, the hospital’s insurance or TPA (Third Party Administrator) desk takes over. They submit a pre-authorisation form to the insurer with treatment details and estimated cost. You can track this in real time on your app under Claims Status or Active Claims. You will also receive SMS or push notification updates as the request moves through approval stages.
Step 4: Get Approval and Proceed with Treatment
The insurer either approves, queries, or partially approves the amount. If queried, the hospital submits additional medical documents. Once approved, you are cleared for admission and treatment under the cashless facility.
You can see the approved amount on the app, which helps you understand what will be covered and plan for any shortfall.
Step 5: Discharge and Final Settlement
At the time of discharge, the hospital submits the final bill to the insurer. The insurer reviews and settles directly with the hospital. You only pay for non-covered items such as consumables, personal charges, or amounts exceeding your sum insured.
Check the final settlement summary on your app under Claims History. Both apps send a detailed breakdown of what was approved, what was deducted, and why.
Step 6: Track Your Claim Post-Discharge
Open the app and go to Claims History or My Claims. You can see the claim ID, amount claimed, amount approved, and current status — such as under review, settled, or pending documents. If documents are pending, you can upload them directly via the app using your phone camera.
Tips to Avoid Claim Rejection
- Always carry your digital e-card to the hospital.
- Do not start treatment at a non-network hospital expecting cashless coverage.
- Ensure the diagnosis code (ICD code) matches your policy’s covered conditions.
- Disclose pre-existing conditions honestly at policy purchase to avoid rejection later.
- Keep all prescriptions, reports, and bills saved on your phone as backups.
Reimbursement Claims (When Cashless Is Not Available)
If you were treated at a non-network hospital, you pay first and then claim reimbursement. On the app, go to Claims > Reimbursement Claim and upload scanned copies of all bills, prescriptions, discharge summary, and lab reports. Track the reimbursement status directly on the app. Settlement is usually completed within 7 to 15 working days after all documents are submitted.
Using your insurer’s mobile app turns a stressful process into a manageable one. The key is to intimate early, stay at network hospitals, and keep your documents ready on your phone.
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