Pays your hospital bill directly to the hospital, so you do not fund a medical emergency from savings. The number that matters is not the premium — it is the room-rent cap, the pre-existing waiting period and the co-pay, because those three decide how much of the bill actually gets paid.
Illustrative figures until sourced from the insurer of record.
Cashless treatment
14,200 network hospitals
Pre and post hospitalisation
60 days before, 180 after
Day-care procedures
Cataract, dialysis, chemotherapy
Restore benefit
Sum insured refills if exhausted
Family floater of 4, ₹10 L sum insured, Bengaluru
Premiums and claim-settlement ratios are illustrative until sourced from the insurer of record.
Reassure 2.0
92.1% settledNo room-rent cap, unlimited restore and pre-existing cover from year three. The benchmark plan on this line.
Optima Secure
98.5% settledDoubles your sum insured from day one at no extra premium, and has the widest network. Costs more and argues less.
Family Health Optima
89.6% settledCheapest here. Has a 1% room-rent cap and a 20% co-pay above 60, both of which bite exactly when you need it.
Read this before you buy.
- Pre-existing conditions during the waiting period, usually 24 to 48 months
- Non-medical consumables — gloves, syringes, administrative charges
- Cosmetic surgery, unless reconstructive after an accident
- Treatment abroad, and experimental or unproven treatment
- The first 30 days of the policy, except accidents
Health is the only line with two completely different claim paths. Cashless is decided in under an hour; reimbursement takes days and is where most disputes happen.
- 01
Show the e-card at the desk
· at admissionThe hospital raises a pre-authorisation with the TPA. This is cashless — you sign, you do not pay. Planned surgery? Tell us 48 hours ahead and it is approved before you arrive.
- 02
TPA pre-authorises
· 42 min medianThe insurer approves an amount, not the whole bill. Anything above it is yours unless it is revised during treatment, which we handle.
- 03
Bill is queried, not just paid
· during stayRoom rent above your cap reduces every linked charge proportionately — surgeon, ICU, nursing. This is where a policy quietly pays 40% less than you expected.
- 04
You pay only the gaps
· at dischargeCo-pay, non-medical consumables and any room-rent excess. Ask for the itemised bill; gloves and syringes are routinely charged and routinely not covered.
- 05
Or reimbursement, if non-network
· 11 daysYou pay first and claim back with originals. Keep every document, including the discharge summary and pharmacy bills — one missing paper restarts the clock.
Buying ₹5 L of cover because it fits the budget. One cardiac procedure in a metro private hospital costs more than that, and a super top-up would have doubled the cover for about ₹2,700 more.