IRDA Directs, Hospitals Cannot Refuse The Cashless Treatment Of Coronavirus.
IRDA has said that hospitals cannot refuse to provide cashless treatment to the insured in the grip of Kovid-19 infection. The regulator has directed the insurance companies to keep an eye on the problems faced by customers in hospitals in cashless medical facilities.
In a circular issued last week by the Insurance Regulatory Authority of India (IRDA), many insurance holders had complained about Corona not having cashless treatment. Hospitals in the network of companies are also shying away from cashless treatment of patients. IRDA has directed the insurance companies to keep pace with the hospitals involved in their network and ensure the facility of cashless treatment under the rules included in the Service Level Agreement (SLA). Companies need to develop robust systems for diagnosing customer problems associated with Covid-19. They will also have to seek feedback from the insured with frequent contact with the hospitals involved in the channel.
Companies will take action on complaints
According to the insurance regulator, if a hospital refuses to provide cashless treatment, the insured should immediately complain to the government agencies of the state or territory concerned. Customers can also send a complaint on the website of the concerned insurance company or via email. IRDA has said that hospitals cannot refuse to provide cashless treatment to the insured in the grip of Covid-19 infection. The regulator has directed the insurance companies to keep an eye on the problems faced by customers in hospitals in cashless medical facilities.
In a circular issued last week by the Insurance Regulatory Authority of India (IRDA), many insurance holders had complained about Corona not having cashless treatment. Hospitals in the network of companies are also shying away from cashless treatment of patients. IRDA has directed the insurance companies to keep pace with the hospitals involved in their network and ensure the facility of cashless treatment under the rules included in the Service Level Agreement (SLA). Companies need to develop robust systems for diagnosing customer problems associated with Covid-19. They will also have to seek feedback from the insured with frequent contact with the hospitals involved in the channel.
Companies will take action on complaints
According to the insurance regulator, if a hospital refuses to provide cashless treatment, the insured should immediately complain to the government agencies of the state or territory concerned. Customers can also send a complaint on the website of the concerned insurance company or via email. After analysing the case, the insurance companies will decide on the action or penalty against the guilty hospital or network provider. The company will also make its information public on its website or portal and the insured will also have to inform it.
IRDA has clarified that as per the rules included in the SLA of the insurance policy, all the network providers (hospitals) will come to the respective company or TPA’s channel, all will have to benefit from the cashless facility. It will be the responsibility of the insurance company to pressurize the concerned hospital to provide adequate facilities to its customers and update the customers through constant contact.
