Nirmala Sitharaman asks IRDAI to ensure timely authorisation for cashless treatment of Corona patients

Finance Minister Nirmala Sitharaman has asked Insurance Regulator IRDAI to ensure timely authorisation for cashless treatment of COVID patients.

Ms Sitharaman spoke to IRDAI Chairman SC Khuntia over the reports that some hospitals are denying cashless insurance. In a tweet, she said, in March last year COVID included as a part of comprehensive health insurance and cashless service is available at networked or even temporary hospitals.

FM Sitharaman in a tweet said, "Reports are being received of some hospitals denying cashless insurance. Spoken to Chairman, IRDAI Shri SC Khuntia to act immediately. In March'20 #Covid included as a part of comprehensive health insurance. Cashless available at networked or even temporary hospitals."

The Minister informed that over nine lakh COVID related claims have been settled by insurance companies for Rs 8642 crore so far. She added that even teleconsultations can be covered in it. The Minister said that IRDAI will direct companies to prioritise authorisations and settlements of Covid cases.

Later, the Ministry of Finance in a tweet said, "It is clarified by IRDAI that where insurers have an arrangement with the hospitals for providing cashless facility, such network hospitals are obligated to provide cashless treatment for all treatments including treatment for COVID-19."

IRDAI in its release said, there are some reports that some hospitals are not granting cashless facility for treatment of COVID-19 despite policyholders being entitled to the cashless treatment under their Policy. In this regard, it is clarified that where insurers have an arrangement with the hospitals for providing cashless facility, such network hospitals are obligated to provide cashless treatment for all treatments including treatment for COVID-19.

All the Network Providers (hospitals) who have signed Service Level Agreements (SLA) with general and health insurers have to mandatorily provide cashless facility for any treatment to the policyholders including Covid-19 treatment in accordance with agreed provisions of SLA and terms and conditions of a policy contract.

Therefore all policyholders that are entitled to the cashless facility at all such network providers (hospital) with whom the Insurance company/TPA has entered into an agreement shall avail the benefit of cashless treatment.

It further said, In the event of denial of the cashless facility at any such enlisted network providers (hospitals) the aggrieved policyholders may send a complaint to the concerned insurance company through https://www.irdai.gov.in/ADMINCMS/cms/NormalData_Layout.aspx?page=PageNo225&mid=14.2

It directed the insurance companies to ensure smooth availability of a cashless facility with all the network providers (hospitals) empanelled with them by actively interacting with the hospitals.