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    Denied cashless COVID-19 treatment? Here's what policyholders should do

    Denied cashless COVID-19 treatment? Here's what policyholders should do

    Denied cashless COVID-19 treatment? Here's what policyholders should do
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    By Anshul   IST (Updated)

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    The Insurance Regulatory Authority of India (IRDAI) has asked all hospitals to provide cashless payment facilities for treatment of coronavirus.

    The Insurance Regulatory Authority of India (IRDAI) has asked all hospitals to provide cashless payment facilities for treatment of coronavirus. IRDAI has asked insurance companies to maintain a communication channel with hospitals for prompt resolution of grievances of policyholders.
    "It is clarified that the policyholders are entitled to cashless facility at all such network providers (hospitals) with whom the insurance company/TPA (third party administrator) has entered into an agreement in accordance to the norms of service level agreement (SLA)," IRDAI said in a circular.
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    In case of denial of cashless facility, it said, policyholders can file a complaint by writing to the grievance redressal officer of the insurer. "The details of same would be on the company's website," it added.
    IRDAI’s move comes after some cases of cashless claims denial were reported.
    The insurance regulator has further asked all insurers to put in place an exclusive grievance redressal mechanism to address complaints relating to the denial of cashless claims.
    "Policyholders whose claims have been denied by hospital should immediately report the same to the appropriate government agencies in the state or area," it said.
    IRDAI added that every general and health insurance company must endeavor to enter into agreements with an adequate number of both public and private sector network providers across the geographical spread.
    Cashless facility ensures that policyholders don't have to pay for treatment and insurers settle the bill with the hospital.
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