What is a Claim intimation and pre-authorisation?
Claim intimation is telling your insurer about a hospitalisation, within the window your policy requires. Pre-authorisation is the cashless approval step, where a network hospital sends your diagnosis and estimate to the insurer to confirm cover before or during treatment. Both are process steps that protect your claim.
Intimation vs pre-authorisation
Intimation is simply informing the insurer — for planned admissions in advance, and for emergencies within the short window the policy specifies. It keeps the claim valid and lets the insurer track it.
Pre-authorisation is specific to cashless: the hospital raises a request with your clinical details and estimated cost, and the insurer approves an admissible amount, sometimes in stages as treatment progresses.
Example
For a planned surgery you intimate the insurer a few days ahead and the hospital raises a pre-authorisation. For an emergency admission, a family member intimates within the policy's window and the hospital seeks approval once you are stable.
Common mistakes
- Not intimating an emergency admission within the policy's window.
- Treating a pre-authorisation approval as the final settled amount — the final figure is confirmed at discharge after review.
- Leaving intimation to the hospital and assuming it is done.
Frequently asked questions
What happens if I miss the intimation window?
Late intimation can complicate a claim, but a genuine delay with a valid reason is often still considered. Intimate as early as you can and keep all documents.
Is pre-authorisation the same as claim approval?
No. Pre-authorisation confirms cashless cover for an estimated amount. The final admissible amount is settled at discharge after the insurer reviews the actual bill.