Indians can now avail of cashless facilities to fund their treatment expenses at any hospital nationwide. This comes after general and health insurance companies decided to grant 100 per cent cashless treatment to medical insurance policyholders from Thursday (25 January).
General and health insurance companies have collaborated with the General Insurance Council, the apex body of general insurer, to launch ‘Cashless Everywhere’ initiative.
Let’s take a look at what it is and how it will benefit policyholders.
How ‘Cashless Everywhere’ will work
The initiative allows policyholders to avail treatment at any hospital without paying any amount, even if that hospital is not in the insurance company’s network.
It empowers the policyholder to get admitted to any hospital of their choice without an advance payment and the bill will be settled by insurance companies on the discharge day, as per Indian Express.
Under this, the customer has to inform the insurance company at least 48 hours before admission. In case of emergency treatment, the policyholder must notify the insurance company within 48 hours of admission.
“The claim should be admissible as per the terms of the policy and the cashless facility should be admissible as per the operating guidelines of the insurance company,” according to the General Insurance Council.
What’s the current situation?
Earlier, the cashless facility was available only at hospitals where respective insurance companies had an agreement or tie-ups.
If a customer opted for a hospital that did not have any such agreement, then they could not get cashless facility. The policyholder had to go for a reimbursement claim, holding up the claim process and leading to disputes.
As per Indian Express, it is difficult for policyholders in rural and semi-rural areas to access network hospitals to opt for the cashless facility.
According to the Insurance Regulatory and Development Authority of India (IRDAI) Annual Report, about 56 per cent of the health claims were settled through the cashless facility during the fiscal 2022-23.
During this period, general and health insurers settled 2.36 crore health insurance claims, paying Rs 70,930 crore towards settlement as compared to Rs 69,498 crore in the previous year, the report added.
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Benefits of ‘Cashless Everywhere’
Tapan Singhel, MD and CEO of Bajaj Allianz General Insurance and Chairman of the General Insurance Council, said the programme has been brought to make “customers’ lives easier”.
“Today if you see only about 63 per cent of customers opt for cashless claims, while the others have to apply for reimbursement claims as they might be admitted to hospitals that are outside their Insurer or TPA (third party agents) network,” he said.
According to Singhel, this puts financial stress on customers, making the process “long and cumbersome.”
Despite having medical insurance, patients often end up paying from their own pockets as their hospital was not impanelled in the insurer’s network.
“The new initiative will encourage more customers to opt for health insurance. We also see this as a step towards reducing and in the long run, eliminating fraud, which has been plaguing the industry in a big way and reducing trust in the system. Overall, it’s a win-win for all the stakeholders,” Singhel was quoted as saying by Indian Express.
If all insurers come up with methods that let customers go cashless at all hospitals, it will improve the experience of policyholders and enhance insurance penetration. “If this is successful, it will be an excellent move. There will undoubtedly be some glitches initially, but once resolved, it will be a fantastic thing for the insured,” Sudip Indani, National Head- Health & Benefits, Howden Insurance Brokers (India), told Indian Express.
With inputs from agencies
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Now, avail ‘cashless’ treatment at any hospital in India. Here’s how
