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Asked to Pay a Deposit Despite Cashless Health Insurance? Here Is What to Do
- •Insurers must approve cashless requests within one hour under IRDAI rules, though official data shows 13 percent of requests missed this deadline between August 2024 and May 2025.
- •Always ask the hospital billing desk for a written breakup of the deposit to identify non-payable items like consumables, room rent limits, or co-payments.
- •Verify your pre-authorisation status with the insurer or third-party administrator, as hospitals often request deposits until approval arrives.
- •Confirm whether the hospital is still in your insurer's network, as tariff disputes can cause sudden suspensions of cashless facilities.
- •Keep stamped receipts and detailed bills if you must pay a deposit during an emergency, and escalate unfair hospital demands to your insurer or IRDAI.
Key Questions Answered
Ask the hospital billing desk for a written breakup of what the deposit covers, check your pre-authorisation status, and confirm if the hospital is still in your insurer's network. If you must pay, keep stamped receipts, bills, and prescriptions to claim reimbursement later or get adjustments at discharge.
Under IRDAI rules, insurers must decide on a cashless pre-authorisation request within one hour. At discharge, final approval is due within three hours, and insurers must bear any extra charges caused by delays.
You can file a written complaint with your insurer's grievance officer, who must resolve it within 14 days. If unresolved, you can approach the IRDAI through the Bima Bharosa portal or call 155255, with the Insurance Ombudsman as the next step.
