The General Insurance Council in consultation with general and health insurance companies has launched ‘Cashless Everywhere’ to extend the cashless facility to policyholders even at hospitals that are not in the network of the insurers.
“Under Cashless Everywhere, 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 subject to certain conditions.
Those seeking to avail Cashless Everywhere, should intimate the insurance company at least 48 hours prior to the admission in case of elective procedures. For emergency treatment, the customer should intimate their insurer within 48 hours of admission. The claim will be admissible as per the terms of the policy and the cashless facility should be admissible as per the operating guidelines of the insurer, the Council said on Wednesday.
At present, if the policyholder chooses a hospital with which the insurance company does not have an agreement or tie-up, the cashless facility is not offered. In such cases, the policyholders should go for a reimbursement claim, further delaying the claim process, the Council, without specifying the date from when Cashless Everywhere will come into force.
“Cashless Everywhere will make customers’ lives easy. Today, about 63% of customers opt for cashless claims while others have to apply for reimbursement claims as they might be admitted to hospitals outside their insurer/TPA network. We feel this puts a significant amount of stress on their finances and makes the process long and cumbersome… wanted to make the whole journey of claims a frictionless process [thus] improving the policyholder’s experience and build greater trust. This will encourage more customers to opt for health insurance,” General Insurance Council Chairman and Bajaj Allianz General Insurance MD and CEO Tapan Singhel said.
The launch of the initiative is also “seen 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,” he said.
