General and health insurance companies have decided to opt for ‘cashless’ treatment under health insurance policies across the country from Thursday.
Under the ‘Cashless Everywhere’ system, the policyholder can get treated in any hospital they choose, and a cashless facility will be available even if such a hospital is not in the network of the insurance company. This means the policyholder can get admitted to a hospital without paying any money and insurance companies will pay the bill on the discharge day.
The General Insurance Council, in consultation with all the general and health insurance companies, is launching the initiative. The cashless facility is currently available only at hospitals where the respective insurance companies have an agreement or tie-ups. If the policyholder chooses a hospital without such an agreement, the cashless facility is not offered now, and the customer has to go for a reimbursement claim, further delaying the claim process.
Tapan Singhel, MD and CEO of Bajaj Allianz General Insurance, and Chairman of the General Insurance Council, said, “today if you see only about 63% 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.”
According to the council, under the ‘Cashless Everywhere’ system, the customer should intimate the insurance company at least 48 hours prior to the admission. “For emergency treatment, the customer should intimate 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,” it said.
“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 said.