Starting January 25, general and health insurance companies in India are set to roll out the ‘Cashless Everywhere’ system for health insurance policies, a move designed to simplify the claims process and enhance policyholder trust. This new initiative will enable policyholders to access cashless treatment at any hospital, regardless of whether the hospital is within the insurer’s network. This system ensures that patients can be admitted without any initial payment, as the insurance company will directly settle the bills at the time of discharge.
Tapan Singhel, Chairman of the General Insurance Council, shed light on the current state of health insurance claims in India. Currently, only about 63% of customers choose cashless claims, primarily due to network restrictions. Those admitted to hospitals outside their insurer’s network face financial burdens and a lengthy reimbursement process. Singhel emphasized the need to streamline this journey, making it a seamless experience that not only improves customer satisfaction but also fosters greater confidence in the insurance system. This overhaul will encourage more people to opt for health insurance and benefit all stakeholders in the long term.
The move to a cashless system across all hospitals marks a significant shift from the previous model, where cashless treatments were only available at network hospitals. For planned admissions, policyholders are required to inform their insurance company at least 48 hours in advance. In emergency scenarios, notification should occur within 48 hours post-admission. It is important to note that the admissibility of claims will continue to be subject to the terms of the policy and the operational guidelines of the cashless facility as outlined by the insurance company.
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