Access Cashless Treatment in Hospitals: Expanded Network for Policyholders | India Business News – Times of India

by The Technical Blogs


MUMBAI: Health insurance policyholders can access cashless treatment in hospitals that are not part of their insurance company’s network.
The General Insurance Council, representing non-life insurance companies, has introduced the “cashless everywhere” initiative to facilitate this.
The programme consolidates each insurer’s hospital network into a unified one. In this setup, participating insurers commit to honouring claims from non-network hospitals by immediately making them part of their network as soon as a claim is reported.
The outcome would be that policyholders can now choose from over 40,000 hospitals instead of a few thousand earlier, depending on the size of their insurer’s network. The initiative aims to protect customers from having to make initial payments for non-networked hospitals, reduce costs and disputes through discussions, and significantly decrease fraud through real-time claims verification.

To use the service, policyholders must inform the insurance company 48 hours before planned procedures and within 48 hours for emergencies. Also, the claim must meet policy terms and follow the insurer’s guidelines for cashless benefits.
Tapan Singhel, MD and CEO of Bajaj Allianz General Insurance and GIC chairman, said that the priority would be to build customer awareness. The second would be for the insurance companies to “move at hyperspeed to sign an MoU with a hospital when a policyholder gets admitted to a non-network hospital”. “When a non-network hospital is used for the first time, we have set a target of signing an MoU within 48 hours. My personal feeling is that given a couple of months’ time, this will open up an amazing experience from a customer perspective,” said Singhel.
Segar Sampathkumar, director, health insurance at the GI Council, said that starting Thursday, companies will work to provide cashless treatment at any hospital the policyholder opts for. “Today, around 63% of the customers utilise cashless facility. That means that 37% are not using the cashless route. One possible reason could be that they are receiving treatment at hospitals that are not part of their insurance company’s network or the hospitals are outside the cashless network,” he said. Sampathkumar added that technology will provide the backbone for cashless, with hospitals and insurance companies plugging into the National Health Authority.
According to Singhel, the objective of the ‘cashless everywhere’ initiative is also to make health insurance more affordable by controlling expenses and leakages.





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