The General Insurance Council, in collaboration with various general and health insurance companies, has introduced the ‘Cashless Everywhere’ initiative. This program allows policyholders the flexibility to receive treatment at any hospital of their choice, with the added benefit of a cashless facility, even if the selected hospital is not within the insurance company‘s network.
Under the cashless facility, policyholders are relieved from the obligation to make upfront payments for hospitalization, contingent upon the claim’s admissibility. Currently, this convenience is restricted to hospitals where the respective insurance company has a pre-existing agreement or tie-up. For non-network hospitals, policyholders typically have to pursue reimbursement claims.
The council outlined that the ‘Cashless Everywhere’ feature comes with the condition that customers must inform their insurer 48 hours prior to admission for elective procedures and within 48 hours post-admission in the case of emergency treatments. Additionally, the claim’s admissibility must align with the policy terms, and the cashless facility should comply with the operating guidelines of the insurer.
Tapan Singhel, MD and CEO of Bajaj Allianz General Insurance, and Chairman of General Insurance Council, emphasized, “Approximately 63 per cent of customers presently opt for cashless claims, leaving others to apply for reimbursement claims when admitted to hospitals outside their Insurer/TPA network. We believe this places a significant financial burden on them and complicates the process.”
Singhel expressed optimism that the ‘Cashless Everywhere’ initiative would streamline the entire claims process, enhancing the policyholders’ experience, fostering greater trust in the system, and encouraging more individuals to consider health insurance. He noted, “We also see this as a step towards reducing and, in the long run, eliminating fraud, which has been a significant issue in the industry, eroding trust in the system. Overall, it’s a win-win for all stakeholders.”
