Reimbursement insurance is a type of health insurance where the policyholder pays the hospital or medical expenses upfront and then claims the amount back from the insurance company. Unlike cashless insurance, the insurer does not pay the hospital directly.
✅ Simple Definition
Reimbursement insurance is a system where the insured pays for treatment first and gets reimbursed by the insurer afterward, according to the policy terms.
✅ How Reimbursement Insurance Works
- You receive medical treatment at any hospital (network or non-network).
- You pay the hospital bill upfront.
- Submit a claim with all required documents to the insurer (bills, prescriptions, discharge summary, etc.).
- Insurer verifies the claim and reimburses you according to your policy coverage.
- You may bear any deductibles, co-payments, or uncovered expenses.
✅ Key Points
- Offers flexibility to choose any hospital.
- May involve more paperwork than cashless claims.
- Claim settlement can take a few days to weeks.
- Some policies provide partial reimbursement if expenses exceed coverage limits.
✅ Example
- You have health insurance with ₹3 lakh sum insured.
- Hospital bill = ₹50,000
- You pay ₹50,000 upfront, submit the bills to your insurer, and they reimburse ₹50,000 (or the covered amount).
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