Deductible in Comprehensive Health Policy
I am very confused about this so being a bit elaborate. Sorry for the inconvenience.
Let's say I have a policy of Company A with 10L cover and a deductible of 1L. I got hospitalized. Bill comes out to be 3L, and gets paid by my corporate cover of Company B via cashless. I go home happy.
3 months later I get hospitalized again under emergency. Family gives health card of 10L policy (Company A) to the TPA desk.
My Questions and doubts are as follows:
1) How is Company A supposed to know that I have spent the deductible amount of 1L in my previous Hospitalisation through the corporate cover of Company B (or cash out of pocket)? They can reject the cashless claim outright and ask me to spend 1L first and then come to them.
2) Let's say Company A does not reject the cashless claim and asks for documents to prove that I have spent the 1L deductible. What documents can they possibly ask for and processing of these documents would delay in the initial approval of the cashless claim right?
3) Is there a way to avoid this delay by informing Company A about my previous hospitalization and upload/send the related documents just after discharge so if I do get hospitalized down the line there won't be any hassle for my family members?
4) If any expert has handled a claim like this before and was able to process it via cashless basis then please provide a list of documents I should always keep ready and might be asked by the insurer so that my family does not have to run around.
5) Is the probability of cashless getting rejected for a policy with a deductible option very high? Should I even go for this option?
Thanks for reading and the replies in advance.