Mumbai: Health insurance policyholders will now have access to cashless hospitalisation in around 40,000 hospitals across the country. The non-life insurers and standalone health insurance companies are in the final leg of forming a list of hospitals on their panel, creating a master network of hospitals which could be utilised by all policyholders.
However, there are two conditions attached to availing of cashless treatment. First is that you will have to intimate your insurer about any planned hospitalisation 48 hours prior to admission.
Second, cashless treatment in a hospital of your choice will also depend on the negotiations on pricing reached between the hospital and your insurance company subject to policy terms and conditions like the sum insured available, coverage under the policy etc.
However, incase of an emergency, the policyholder can be admitted immediately and intimation can be done 48 hours after admission.
The Insurance Regulatory and Development Authority of India (IRDAI) and the General Insurance Council would be formally announcing the nationwide common cashless hospital network in a press conference here
on January 24, sources said.
Currently, cashless settlement is available in 49 per cent of the hospitals numbering around 15000-20,000 hospitals. Millions of policyholders are likely to benefit through this move.
“We are trying to extend cashless settlement to non-network hospitals using the network of another insurer. So we have created a list of 40,000 hospitals that are on the panel of all insurance companies put together where cashless treatment can be taken.
For example, my customer goes to a hospital, not in my panel but the hospital is in another insurer’s panel, then we will extend a cashless settlement in the non-network hospital by negotiating with the hospital for that transaction. If the rates or other terms are not agreed by insurer and hospital then cashless may not happen,” explained a senior official of an insurance company involved in the process. However, such instances would be very few since most of these hospitals are already in the network of insurers extending cashless facility added the official.
According to sources, the industry has also progressed considerably on another initiative of creating a common empanelment process of hospitals, where there will be a common panel for all hospitals. The idea is to make health insurance more affordable with the ease of getting cashless treatment.
