To facilitate this, the General Insurance Council, which represents non-life insurance companies, has introduced the “Cashless Everywhere” initiative.
The program consolidates the benefits of each insurer Hospital network to a unified one. In this case, the participating insurers undertake to fulfill claims Out-of-network hospitals by immediately adding them to their network as soon as damage is reported.
The result would be that insured people would now be able to choose from over 40,000 hospitals, depending on the size of their insurer's network, instead of a few thousand previously. The goal of the initiative is to protect customers from having to make initial payments for out-of-network hospitals, reduce costs and disputes through conversations, and significantly reduce fraud through real-time claims verification.
To use the service, policyholders must inform the insurance company 48 hours before planned procedures and within 48 hours in the event of an emergency. In addition, the claim must comply with the insurance conditions and comply with the insurer's guidelines for cashless benefits.
Tapan Singhel, MD and CEO of Bajaj Allianz General Insurance and GIC Chairman, said the priority will be to increase customer awareness. The second option would be for insurance companies to “quickly sign a memorandum of understanding with a hospital when a policyholder is admitted to an out-of-network hospital.” “When an out-of-network hospital is used for the first time, we aim to sign an MoU within 48 hours. My personal impression is that this will provide an amazing experience for a customer with a few months of perspective,” Singhel said.
Segar Sampathkumar, director of health insurance at GI Council, said that from Thursday, companies will work to provide cashless treatment at any hospital the policyholder opts for. “Today around 63% of customers use the cashless option. This means that 37% do not use the cashless option. A possible reason could be that they are seeking care at hospitals that are not in their insurance company's network, or that the hospitals are doing so outside of the cashless network,” he said. Sampathkumar added that the technology will form the backbone for cashless payments, with hospitals and insurance companies tying up with the National Health Authority.
According to Singhel, the aim of the 'Cashless Everywhere' initiative is also to make health insurance more affordable by controlling expenses and leakages.
