IRDAI clarifies on cashless claims in COVID-19 cases, hospitals told to provide cashless treatments to patients
New Delhi | Jagran Business Desk: The Insurance Regulatory and Development Authority of India (IRDAI) on Thursday clarified that wherever insurers have an arrangement with the hospitals for providing cashless facility, such network hospitals are obligated to provide cashless service for all treatments, including that for for COVID-19.
“There are some reports that 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,” IRDAI noted in a statement on Thursday.
The clarification comes on a direction by Finance Minister Nirmala Sitharaman to the IRDAI to resolve the issue at the earliest amid reports of several COVID-19 patients being denied cashless health insurance claims by hospitals and insurance companies.
Sitharaman on Thursday asked IRDAI chairman S C Kunthia to "act immediately" to address the complaints of denial of cashless claims by insurance companies.
She also mentioned that more than 9 lakh COVID-related claims for Rs 8,642 crore have been settled by insurance companies.
"Reports are being received of some hospitals denying cashless insurance. Spoken to Chairman, IRDAI Shri SC Khuntia to act immediately. In March'20 #Covid included as a part of comprehensive health insurance. Cashless available at networked or even temporary hospitals," the minister said in a series of tweets.
All the network providers (hospitals), who have signed Service Legal Agreements (SLA) with general and health insurers, have to “mandatorily” provide cashless facility for any treatment to the policyholders, including for Covid-19, the regulatory body noted further.
In the event of being denied cashless treatment, the aggrieved policyholders, IRDAI said, can send a complaint to the concerned insurance company. In the release, it also provided details and email addresses of Grievance redressal officers of insurance companies.
“Insurance companies have also been directed to ensure smooth availability of cashless facility with all network providers,” IRDAI added.
India registered over 3.14 lakh new coronavirus cases in a day, the highest-ever single-day count recorded in any country, taking the the total tally of COVID-19 cases in the country to 1,59,30,965.
According to the Union Health Ministry data updated on Thursday, a total of 3,14,835 fresh infections were registered in a span of 24 hours, while the death toll increased to 1,84,657 with a record 2,104 new fatalities.
Registering a steady increase for the 43rd day in a row, the active cases have increased to 22,91,428 comprising 14.38 per cent of the total infections.
Posted By: Abhinav Gupta