Now onwards Hospitals with 15 beds, registered under the Clinical Establishment Act, can provide cashless hospitalization to health insurance policyholders.
The General Insurance Council (GIC) on Wednesday launched the “Cashless Everywhere” initiative under which health insurance policyholders will have the freedom to choose any hospital for their treatment. Furthermore, the cashless facility will be extended to hospitals that may not be part of the insurance company’s network.
The Cashless Everywhere initiative was launched by the General Insurance Council, in consultation with all general and health insurance companies, the report said. The facility consolidates each insurer’s hospital network into a unified one. Further, insurers honour claims from non-network hospitals by immediately making them part of their network when a claim is reported. With the above initiative of GIC, Health insurance policyholders will now have access to cashless hospitalisation in around 40000 hospitals across the country. The initiative aims to protect customers from having to make initial payments for non-network hospitals, cut costs, end disputes through discussion, and significantly reduce fraud through real-time claims verification.
The council said that the ‘cashless everywhere’ facility will be subject to customers intimating their insurer 48 hours before admission for elective procedures, and 48 hours post admission in case of emergency treatments. 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 insurer.
As per the press reports, Tapan Singhel, Chairman of the General Insurance Council and MD and CEO of Bajaj Allianz General Insurance said that 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/TPA network. “We feel this puts a significant amount of stress on their finances and makes the process long and cumbersome,” he said.
The ‘cashless everywhere’ facility is expected to make the whole claims journey a frictionless process, which will improve policyholders’ experience, build greater trust in the system, and encourage more customers to opt for health insurance, he added.
“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” he stated.
