The insurance regulatory body IRDAI has asked all network hospitals to offer cashless treatment if the case be specified in the health insurance contract.
The directive has come as it has come to light that some of the hospitals are refusing to offer such a facility even when the policyholders are entitled for it. "Hospitals who have signed Service Level Agreement (SLA) with general and health insurers have to mandatorily provide cashless facility for any treatment to the policyholders including Covid-19 treatment in accordance with the agreed provision of SLA and terms and conditions of policy contract," the Insurance Regulatory and Development Authority (IRDAI) said.
Now if the hospital denies such a service, the consumer may make a complaint to the respective insurer. Also, the IRDAI's website has the list of details and email IDs of grievance redressal officers of insurance firms. On the irdai.gov.in, you need to click on grievance and then on functions.
Finance Minister Nirmala Sitharaman on the severity of the crisis asked IRDAI Chairman Kunthia to "act immediately" to address the complaints of denial of cashless claims by insurance firms. The FM underscored that more than 9 lakh COVID-related claims for Rs 8,642 crore have been settled by insurance companies as of April 20.