General Insurance Council, in consultation with all general and health insurance companies, has launched the ‘Cashless Everywhere’ initiative, wherein policyholders can get treated in any hospital they choose, and a cashless facility will be available even if such a hospital is not in the network of the insurance company.
Under the cashless facility, policyholders don’t need to pay for treatment out of pocket in the event of hospitalisation, subject to admissibility of the claim. Currently, the facility is only available at hospitals where the respective insurance company has an agreement or tie-up, and for other hospitals policyholders need to opt for reimbursement claims.
The council said that the ‘cashless everywhere’ facility will be subject to customers intimating their insurer 48 hours prior to admission for elective procedures, and 48 hours post admission in case of emergency treatments. Further, the claim should be admissible as per the terms of the policy and the cashless facility should be admissible as per the operating guidelines of the insurer.
Frictionless process
“Only about 63 per cent of customers opt for cashless claims while the others have to apply for reimbursement claims as they might be admitted to hospitals that are outside their Insurer/TPA network. We feel this puts a significant amount of stress on their finances and makes the process long and cumbersome,” said Tapan Singhel, MD and CEO of Bajaj Allianz General Insurance, and Chairman of General Insurance Council.
The ‘cashless everywhere’ facility is expected to make the whole claims journey a frictionless process, which will improve policyholders’ experience, build greater trust in the system, and encourage more customers to opt for health insurance, he added.
“We also see this as a step towards reducing and in the long run, eliminating fraud, which has been plaguing the industry in a big way and reducing trust in the system. Overall, it’s a win-win for all the stakeholders”.