Health insurance: Cashless treatment at any hospital now as insurers launch new initiative

The General Insurance Council on Wednesday announced a drive aimed at making cashless hospitalization available to policyholders even in non-empanelled hospitals. Hospitals with 15 beds, and registered with the respective state health authorities under the Clinical Establishment Act can offer cashless hospitalization now. In the event of hospitalization, policyholders need not pay for treatment out of their pockets as the expenses would be covered by the insurance companies concerned. This is subject to the claim of being admissible, as per the council.

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Under the ‘Cashless Everywhere’ drive, efforts will be made to ensure that policyholders can get treated in any hospital they choose with a cashless facility, subject to certain conditions. The conditions include that the policy of the individual concerned is admissible and the insurance company should be informed 48 hours before hospitalization in the non-empanelled hospital. There will also be the option of informing the insurance company within 48 hours of hospitalization.

The council’s Chairman Tapan Singhal said that if a policyholder chooses a hospital without such a pre-agreement, the cashless facility is not offered, and the customer has to go for a reimbursement claim, which further delays the claim process. This will be a thing of the past, he said, adding the objective is to ease the burden of policyholders who get treated in a hospital, not in the insurer’s network.

Currently, cashless facilities are available only at about 40,000 empanelled hospitals, he said.

Singhal, also the chief executive of Bajaj Allianz General Insurance, said it has been the constant endeavor of the council to simplify the lives of policyholders and bring positive changes that benefit them.