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Question:

Under an Individual Health Insurance policy, what is the process for direct billing or cashless claim settlement with hospitals in the UAE?

Answer

Direct billing, or cashless claim settlement, is a common feature of health insurance in the UAE. Here's how it generally works:

  • Network hospitals: You must use a hospital or clinic as part of your insurer's network.
  • Health Insurance ID or Emirates ID: You must provide valid proof of health insurance or Emirates ID at admission or treatment.
  • Preauthorization: Preauthorization from the insurance company might be required for some procedures.
  • Claim submission: The hospital will typically submit the claim directly to the insurance company.
  • Payment: If the treatment is covered, the insurer or broker will help you claim it directly at the hospital, and you'll only be responsible for any co-payments, deductibles, or non-covered services.

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