Health Insurance Rules Change: Now cashless treatment in all hospitals

The General Insurance Council (GIC) in consultation with general and health insurance companies has launched the ‘Cashless Everywhere’ initiative to expand cashless treatment in all hospitals. A report was earlier published that cashless treatment facility will be available in all hospitals from January 2024.

After this facility, health insurance policy holders can now avail cashless facilities even in hospitals that are not in the insurance company’s network.

What was the facility in the past:

Earlier, policy holders could avail cashless facility only at hospitals in the insurance company’s network. For treatment in hospitals not partnered with insurance companies, the policyholder had to pay from his own pocket. But under the ‘Cashless Everywhere’ initiative, now policyholders can get treatment at any hospital of their choice.

How to avail this facility?

1. Certain conditions will apply where customers planning treatment need to inform their insurance company 48

hours in advance to avail cashless facility.

2. In case of emergency treatment you must inform your insurance company within 48 hours.

3. At present, cashless facilities are available only in around 40,000 empaneled hospitals.

4. If the insured is undergoing treatment for an illness which is not covered by the terms and conditions of the policy, the insurance company will reject the non-cash claim.

When can these benefits be availed?

1. The General Insurance Council (GIC) has informed that this facility has been implemented immediately. This means you can avail cashless facility at any hospital from today.

2. Currently cashless treatment is only 63 percent of total claims. But IRDAI wants to increase it to 100 percent. Going cashless will reduce bogus health insurance claims and also reduce the burden on policyholders’ pockets. This initiative will encourage more consumers to choose health insurance, control costs and eliminate fraud related to claims.