In a groundbreaking move, the General Insurance Council (GIC), in collaboration with general and health insurance companies, has introduced the ‘Cashless Everywhere’ initiative. This transformative step allows health insurance policyholders to access cashless treatment at any hospital, irrespective of whether it is part of the insurer’s network.
Previously, policyholders could only avail cashless treatment at network hospitals, leading to out-of-pocket expenses and cumbersome claim reimbursement processes if treated at non-network hospitals. With the ‘Cashless Everywhere’ system:
1. Freedom to Choose Hospitals: Policyholders can choose any hospital for treatment, even if it is not in the insurer’s network.
2. Cashless Settlement: The insurance company will settle the medical expenses directly with the hospital, offering a seamless cashless experience.
To avail of the ‘Cashless Everywhere’ facility at a non-empanelled hospital, policyholders must adhere to the following guidelines:
1. Advance Notification: For elective procedures, inform the insurance company at least 48 hours before admission.
2. Emergency Notification: In case of emergency treatment, notify the insurance company within 48 hours of admission.
3. Admissible Claim: The claim should be admissible as per the policy terms, and the cashless facility should comply with the insurer’s operating guidelines.
The new initiative aims to alleviate financial stress on policyholders during hospitalization and streamline the claims process. It’s particularly beneficial for individuals residing in tier 2 and tier 3 regions, offering them access to quality healthcare without the need for reimbursement hassles.
Tapan Singhel, MD and CEO of Bajaj Allianz General Insurance, emphasized the frictionless claims process and improved policyholder experience, fostering trust in the system. The move is expected to encourage more individuals to opt for health insurance.
Siddharth Singhal, Business Head – Health Insurance at Policybazaar.com, highlighted the positive shift in the health insurance industry and the reduction of financial burdens associated with reimbursement processes.
The ‘Cashless Everywhere’ initiative is a significant collaboration within the health insurance industry, providing policyholders with unprecedented flexibility and convenience in accessing healthcare services nationwide.