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Network Hospitals Cannot Deny Cashless COVID Claims: IRDAI

The Insurance Regulatory and Development Authority of India has directed all the health insurance companies in India to ensure the availability of cashless facilities for Covid-19 treatment. Those who are denied treatment can register a complaint.

There have been reports of some hospitals that are not granting cashless treatment facilities and insisting on cash payments from policyholders who are undergoing Covid-19 treatment. IRDAI has directed both standalone and general health insurance companies to register a complaint against such hospitals.

For cashless treatment, the regulator has advised insurance companies to ensure that the rates charged to the policyholders are as per the rates agreed to by network providers and no additional charges are levied for the same treatment. Also, the health insurance reimbursement claims should be settled as per the terms and conditions.

How to Raise A Complaint?

You can file a complaint if a network hospital rejects a cashless facility and send a complaint to the concerned Insurer. If the insurer does not provide a response to the policyholder within a reasonable time or is dissatisfied with the response, then he/she can approach the IRDAI’s consumer affairs department with their grievance redressal cell.

The complaints need to be file directly by the policyholders and not their agents or advocates or any third parties. Remember, complainants need to provide all the details in the complaint registration form and put it on the https://www.policyholder.gov.in/Report.aspx

Written By: PolicyBazaar - Updated: 30 April 2021
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Disclaimer: Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

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