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Now, You Can Access Cashless Facility Outside The Insurer’s Hospital Network

The General Insurance Council has launched a “Cashless Everywhere” facility, allowing policyholders to access hospitals outside the insurance company’s network of hospitals.

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Outlook Money
January 25, 2024
Life Insurance Policy Help In Retirement

Life Insurance Policy Help In Retirement

The General Insurance Council has launched the “Cashless Everywhere” facility on Wednesday to provide policyholders the freedom to choose hospitals even if they are outside the insurance company’s network of hospitals. The council is a representative body of registered general insurers under the Insurance Regulatory and Development Authority of India (Irdai). 

In its press note on Wednesday, the council said it launched the cashless facility in consultation with all general and health insurance companies to provide policyholders with the flexibility in choosing their preferred hospitals for treatment regardless of the insurer’s hospital network.

Until now, health insurance companies extended the cashless facility only to their network of hospitals with whom they have a tie-up. Policyholders need not pay from their pockets for treatments, as the insurance company bears the entire cost, provided the claim is permissible.

Also Read: How Does Bima Sugam Simplify Insurance Purchase And Claim Settlement Process For Seniors?

However, if the policyholder wants to get treatment outside the insurer’s hospital network, they have to pay from their pockets and later get the bills reimbursed by the insurance company. This process is cumbersome and time consuming compared to the cashless facility.

With the “Cashless Everywhere” facility, policyholders need not check the network of hospitals while buying their health insurance policy, as they can access any hospital for treatment.

Commenting on the “Cashless Everywhere” initiative in the press release, Tapan Singhel, MD and CEO of Bajaj Allianz General Insurance and Chairman of the General Insurance Council, said: “Cashless Everywhere will make customers’ lives easy. Today, only about 63 per cent of customers opt for cashless claims, while others apply for reimbursement as they might be admitted to hospitals outside their insurer network. This puts significant stress on their finances.”

Singhel added that it will encourage more customers to opt for health insurance and help reduce fraud, which has been “plaguing the industry in a big way; it’s a win-win for all stakeholders.”

To avail of the cashless facility, policyholders must inform the insurance company at least 48 hours before hospitalisation involving an elective procedure and emergency hospitalisation. The council said the facility will be extended to policyholders as per the insurance company’s operating guidelines and admissible claims.

Rudraraju Rajgopal, Executive Vice President & National Head, Accident & Health Claims, TATA AIG General Insurance Company Limited, opines that this move is to reduce financial stress and enhance customer experience. He says, “This industry wide collaboration is not only beneficial for policyholders but also signifies a positive shift in the health insurance industry.”

This facility is a big relief for senior citizens as they no longer need to worry about the hospital network or arrange cash for treatment in other hospitals. They can now go to the nearest hospitals for treatment without paying anything out of pocket.

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