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| Hospitals denying health insurance, COVID cashless claim: UDA | | |
EARLY TIMES REPORT
JAMMU, June 13: Taking cognizance of the issue of some hospitals denying cashless facility for treatment of COVID-19, the United Democratic Alliance (UDA), Convenor Rajiv Mahajan has reiterated that policyholders are entitled to cashless facility at all network hospital with whom an insurance company has entered into an agreement for the same.
“The United Democratic Alliance (UDA) is aware of reports that some hospitals are not granting cashless facility for treatment of COVID-19 despite such arrangements with the insurers. It is also brought to the notice of the UDA that some of these hospitals are also demanding cash deposits from the policyholders,” Mahajan said in a statement on Sunday.
Mahajan said that as per 31 (d) of IRDAI (Health insurance) Regulations, 2016, general and health insurance companies are expected to enter into agreements with enough number of public and private sector healthcare providers across the geographical spread. Wherever such agreements are entered into, he said that it is essential for all such hospitals to provide cashless facility for any treatment to the policyholders including COVID-19 treatment in accordance with terms of agreement and the terms and conditions of policy contract.
Rajiv asked policyholders to complain to the concerned insurance company if a hospital denies cashless facility to any person. When a complaint is received from a policyholder on denial of the cashless facility, Mahajan has asked the insurance company to take appropriate action against such hospitals.
Mahajan also asked insurance companies to ensure that the policyholder knows about the availability of the cashless facility at the hospitals in the insurer’s network.
It has also advised insurance companies to put in place an exclusive grievance redressal mechanism to address the grievances of policyholders relating to the denial of cashless facility for COVID-19 and other grievances against such hospitals that are enlisted as network providers. “Insurance companies shall also put in place continuous communication channel with all the network providers for prompt resolution of the grievances of policyholders.” The signatories to the statement included Lt Gen. (Retd.) Pradeep Singh Mehta Principal Advisor, Manish Sahni (Former Convener), IG (Retd) Sudhir Dogra General Secretary, Co- Conveners Col. (Retd.) S.S Pathania, Com. (Retd.) Bhushan Devan, Col. (Retd.) PS Jamwal, Col. J.P Singh, (Retd. DC) Vijay Sharma, (Retd. DC) M. L. Sharma, Er. V.K. Gupta (Retd. SE) and others. |
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