The Insurance Regulatory and Development Authority of India (IRDAI) has directed the network hospitals to provide cashless treatments to Covid-19 patients.
It has been clarified by IRDAI that where insurers have an arrangement with the hospitals for providing cashless facility, such network hospitals are obligated to provide cashless treatment for all treatments including treatment for COVID-19.
The Authority reminded the hospitals that they are obligated to provide cashless treatment to for all treatments including, COVID-19,
There are some reports that some hospitals are not granting cashless facilities for treatment of Covid-19 despite policyholders being entitled for the cashless treatment under their Policy. In this regard, it is clarified that where insurers have an arrangement with the hospitals for providing cashless facilities, such network hospitals are obligated to provide cashless treatment for all treatments including treatment for COVID-19.
Therefore, the IRDAI directed the general and health Insurers shall ensure that all such network provider hospitals extend cashless facilities for any treatment to the policyholder including COVID-19 treatment in accordance with agreed provisions of SLA and terms and conditions of the policy contract.
“Where any network provider denies cashless facility and deviates from agreed terms of the SLA, insurance companies shall take appropriate action against such network providers as provided in SLA in addition to taking up appropriate action,” IRDAI warns. The IRDAI said that the Insurers have also been directed to ensure smooth availability of a cashless facility with all network providers empanelled with them by putting in place continuous communication channels with all the network providers for prompt cashless services and for resolution of grievances of policyholders if any.
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