Cashless Facility in Hospitals Cannot Be Denied to Policyholders: IRDAI

The Insurance Regulatory and Development Authority of India (IRDAI) received reports of some hospitals denying cashless treatment facilities to policyholders for coronavirus despite the arrangements made by the insurance companies. Moreover, some of these hospitals are also asking policyholders to make cash deposits. As a result, IRDAI reiterated that hospitals cannot deny cashless facilities to policyholders.

Read More

Policybazaar exclusive benefits
  • 30 minutes claim support*
  • 50,000 claims approved in last 15 months*
  • Schedule home visit with our advisors
  • Get a plan based on your medical needs

*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply

*Tax benefit is subject to changes in tax laws. Standard T&C Apply

Back
All health plans cover Covid-19 treatment
  • 1
  • 2
  • 3
  • 4

Who would you like to insure?

  • Previous step
    Continue
    By clicking on “Continue”, you agree to our Privacy Policy and Terms of use
    Previous step
    Continue

      Popular Cities

      Previous step
      Continue
      Previous step
      Continue

      Do you have an existing illness or medical history?

      This helps us find plans that cover your condition and avoid claim rejection

      Get updates on WhatsApp

      What is your existing illness?

      Select all that apply

      Previous step

      When did you recover from Covid-19?

      Some plans are available only after a certain time

      Previous step
      Advantages of
      entering a valid number
      You save time, money and effort,
      Our experts will help you choose the right plan in less than 20 minutes & save you upto 80% on your premium

      As per the provisions of regulation 31 (d) of IRDAI (Health insurance) Regulations, 2016, health and general insurance companies should have an agreement with both private and public healthcare providers and hospitals across the geographical spread. The Insurance Companies are required to publish a (list of the network hospitals) with whom they have a service level agreement shall be published on their websites along with the TPA.

      All General and Health Insurers (Except ECGC and AIC)

      All the Insurance providers in this regard are advised to ensure that where the insured person is notified about the cashless facility at network hospitals, the policy holder should receive cashless hospitalization benefits as per the policy terms and conditions and the Service Level Agreement between the insurer and the hospitals.

      • Therefore, IRDAI has advised the insurance companies to put a grievance redressal mechanism in place to address the issues faced by policyholders relating to the denial of COVID-19 cashless treatment in the listed network hospitals.
      • The insurer shall ensure a well-established communication channel with all the network hospitals for prompt resolution of the issues faced by the policyholders
      • In case any network hospital denies cashless treatment against the agreed Service Level Agreement (SLA), the insurer shall take an appropriate action
      • Also, if the network hospitals misconduct with the policyholders’ interests against the SLA, such instances shall be reported to the concerned State Government agencies. The insurance companies should publish about the actions taken against such hospitals on their website to keep the public informed
      • And all this has the approval of the competent authority

      The details and email ids of Grievance redressal officers of Insurers can be accessed from their website.

      IRDAI has directed the Insurance companies to ensure smooth cashless treatment to the policyholders in all the network hospitals as per the agreed policy terms.  

      Therefore, it is clear that the policyholders can avail cashless facility in all the network providers’ or hospitals that are registered with the insurer as per the norms of the Service Level Agreement (SLA)

      Search
      Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

      Health insurance articles

      Recent Articles
      Popular Articles
      Does Health Insurance Cover H3N2 Virus?

      20 Mar 2023

      The seasonal H3N2 virus is rapidly spreading across India. As per
      Read more
      Common Wellness Benefits Offered by Health Insurance Plans

      14 Feb 2023

      Health is the biggest wealth in the true sense. No matter how much
      Read more
      Should You Buy a Super Top-up Health Insurance Policy?

      18 Jan 2023

      India is abuzz with a variety of health insurance plans to cater
      Read more
      6 Reasons Why Your Cashless Health Claims Can Get Denied

      18 Jan 2023

      Cashless claims are one of the most lucrative benefits of buying a
      Read more
      Check Out the Mandatory KYC Documents for Health Insurance

      30 Dec 2022

      The Insurance Regulatory & Development Authority of India
      Read more
      What are the Normal Thyroid Stimulating Hormone (TSH) Levels as Per Age?
      The thyroid gland is an important gland responsible to produce the right amount of hormones for normal body
      Read more
      How to Apply for Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (PM-JAY)?
      Ayushman Bharat Yojana is a flagship health insurance scheme launched by the Government of India to offer universal
      Read more
      10 Major Benefits of Ayushman Bharat Yojana
      Pradhan Mantri Jan Arogya Yojana (PM-JAY) is the second component under Ayushman Bharat Scheme. PM Narendra Modi
      Read more
      Best Health Insurance Plans for Senior Citizens in 2023
      Senior citizens are the most prone to diseases. Considering the medical inflation in India, buying health insurance
      Read more
      Income Tax Slab for Women: Guide to Exemptions and Rebates
      In India, every person who earns beyond a certain limit is liable to pay income tax to the government. The tax
      Read more

      top
      Close
      Download the Policybazaar app
      to manage all your insurance needs.
      INSTALL