For most people, the idea of cashless health insurance sounds simple. You go to a hospital, get treated, and walk out without paying a rupee. Yet, in reality, many patients find themselves swiping their card or counting cash at the billing counter despite having a valid policy. It could be a few thousand for consumables or several lakhs because of a missed pre-authorisation or a room rent cap.

These surprises are rarely due to claim rejection. They usually arise from policy terms that were either misunderstood or overlooked. As India’s health insurance coverage expands, the focus is shifting from “having a policy" to “having the right policy." True protection means ensuring your insurer pays the full amount directly to the hospital without any gaps. Here’s how to make that happen.

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