The Insurance Regulatory and Development Authority of India (IRDAI) has directed network hospitals to provide cashless treatment to insurers. The development comes after many Covid 19 patients complained that these hospitals were not providing cashless treatment.
Reminding these hospitals that they are obligated to provide cashless treatment to for all treatments including, Covid 19, IRDAI said, “There are some reports that some hospitals are not granting cashless facility for treatment of Covid-19 despite policyholders being entitled for the cashless treatment under their Policy. In this regard, it is clarified that where insurers have an arrangement with the hospitals for providing cashless facility, such network hospitals are obligated to provide cashless treatment for all treatments including treatment for COVID-19.”
Confirming about the IRDAI directives, the Ministry of Finance tweeted, “It is clarified by IRDAI that where insurers have an arrangement with the hospitals for providing cashless facility, such network hospitals are obligated to provide cashless treatment for all treatments including treatment for COVID-19.”
It said all the Network Providers (hospitals), who have signed Service Level Agreements (SLA) with general and health insurers, have to mandatorily provide cashless facility for any treatment to the policyholders, including Covid-19 treatment in accordance with agreed provisions of SLA and terms and conditions of policy contract.
Therefore, all policyholders that are entitled to cashless facility at all such network providers (hospital) with whom the Insurance company/TPA has entered into an agreement shall avail the benefit of cashless treatment.
In the event of denial of cashless facility at any such enlisted network providers (hospitals) the aggrieved policyholders may send a complaint to the concerned insurance company. The details and email ids of Grievance redressal officers of insurance companies can be accessed from the website of the insurers or at the link:
Insurance companies have also been directed to ensure smooth availability of cashless facility with all the network providers (hospitals) empaneled with them by actively interacting with the hospitals.