Acting tough against insurance companies and their networked hospitals, IRDAI has asked policyholders to lodge complaints against hospitals with insurance companies immediately if they demand money in cashless facility.
IRDAI found that some hospitals have been demanding cash deposits from policyholder for covid-19 treatment despite having cashless agreement with insurers.
IRDAI said, “There are reports of instances of some hospitals charging differential rates and insisting on cash deposits from the policyholders for providing treatment for COVID-19 despite having cashless arrangement with Insurers. Charging differential rates to policyholders, demanding advance deposits and denying cashless treatment to policyholders of health insurance policies is not only detrimental to the interest of policyholders but may also violative of the service level agreement between the service provider hospitals and the insurance companies.”
Insurance companies have tie-ups with hospitals across the country and these hospitals will have to provide cashless facility for any treatment to the policyholders including covid-19 treatment, said IRDAI.
Expressing its concerns over such instances, IRDAI further said, “In this difficult time of a second wave of Covid-19 pandemic, network provider hospitals are requested to rise to the occasion and to provide cashless treatment to policyholders for all treatments covered by the insurance policy including Covid-19 as per the terms of service level agreements. All hospitals are also requested not to differentiate the patients in terms of admission or treatment whether they are insured or not insured or whether they pay cash or avail of cashless facility. A gesture of this nature on the part of hospitals in these difficult times will re-inforce the confidence of the public in the healthcare system including health insurance and build trust.”
IRDAI has asked insurance companies to take up the matter with the state government if network hospitals still deny cashless facility to policyholders.
Further, IRDAI has asked insurance companies to ensure smooth availability of cashless facility with all network hospitals.
