Plum presents ‘e-imburse’ to simplify the health insurance claims process. Details here

Plum, India’s leading insurtech platform, which provides group health insurance and business insurance solutions to more than 3500 corporations, has introduced ‘e-imburse’, a digital-first solution for reimbursement claims.

Historically considered a complex procedure, reimbursement claims involved employees covering medical expenses and treatments up front, and then seeking reimbursement from their insurance provider. The documentation needed for making a reimbursement claim includes:

● A filled and signed claim form

● Original hospital bills, inclusive of prescriptions, pharmacy bills, and receipts

● Diagnostic and laboratory reports

● Medical certificates authenticated by a physician

● The original discharge summary

The reimbursements constitute 40

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National Health Insurance: All you need to know

On 12 June 2023, the National Assembly (NA) passed the National Health Insurance (NHI) Bill.

The NHI Bill seeks to provide universal access to health care services in the country in accordance with the National Health Insurance White Paper and the Constitution of South Africa.

The Bill envisages the establishment of a National Health Insurance Fund and sets out its powers, functions and governance structures. The fund will purchase health care services for all users who are registered with it.

The Bill will also create mechanisms for the equitable, effective and efficient utilisation of the resources of the fund to

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Health Insurance: How to ensure your claim doesn’t get delayed or rejected? Experts explain

From checking the hospital, to intimate your insurance company about your illness to the way that you may get some relief, experts guide how you should dot the I’s and cross the T’s.

“Typical mistakes in insurance claims include providing inaccurate information, missing required documents, and not adhering to claim submission deadlines,” says Rakesh Goyal, Director, Probus Insurance.

“Taking treatment in one of the restricted or blacklisted hospitals as decided by the insurance company,” says Siddharth Singhal, Business Head – Health Insurance, Policybazaar.com. Customers need to check for such a list of blacklisted hospitals in their area before filing a

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Will going 100% cashless increase my health insurance premium?

How does the implementation of a 100% cashless network affect my current health insurance coverage? Will my premiums increase as a result? What is the relevance of the hospital network of my insurer now if all hospitals have become cashless. Additionally, can the service quality be expected to remain consistent across all insurers in light of this change?

—Name withheld on request

Going 100% cashless is a very positive development taken by the regulator. This allows policyholders to avail cashless treatment across many hospitals and comes at no additional cost.

So, your premium would not increase. To avail this facility,

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