Tag: cashless policy

IRDAI issues clarification on cashless claims in Covid-19 cases

Banking & Finance

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Insurance Regulatory and Development Authority of India (IRDAI) has clarified that wherever insurers have an arrangement with the hospitals for providing cashless facility, such network hospitals are obligated to provide cashless service for all treatments including treatment for Covid-19.

This clarification comes in the backdrop of some reports that some hospitals are not granting cashless facility for treatment of Covid-19 despite policyholders being entitled for the cashless treatment under their policy.

Finance Minister Nirmala Sitharaman had earlier held talks with the IRDAI Chairman SC Kunthia on the problems some have faced and the need to address it.

The FM had earlier tweeted, “Reports are being received of some hospitals denying cashless insurance. Spoken to Chairman, IRDAI Shri SC Khuntia to act immediately. In March’20 #Covid included as a part of comprehensive health insurance. Cashless available at networked or even temporary hospitals.”

All the Network Providers (hospitals) who have signed Service Level Agreements (SLA) with general and health insurers have to mandatorily provide cashless facility for any treatment to the policyholders including Covid-19 treatment in accordance with agreed provisions of SLA and terms and conditions of policy contract.

Therefore, all policyholders that are entitled to cashless facility at all such network providers (hospital) with whom the insurance company/TPA has entered into an agreement shall avail the benefit of cashless treatment.

In the event of denial of cashless facility at any such hospitals the aggrieved policyholders may send a complaint to the concerned insurance company. The details and email ids of grievance redressal officers of insurance companies can be accessed from the website of the insurers.

Insurance companies have also been directed to ensure smooth availability of cashless facility with all the network providers (hospitals) empaneled with them by actively interacting with the hospitals.

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How cashless garage facility benefits you

Personal Finance

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Two neighbours’ daily routine of watering plants leads to an interesting conversation.

Bindu: I see you have a lot of new pots.

Sindu: Yes. I wanted to grow some vegetables at home.

Bindu: Quite an investment, I would say. How did you get all the seeds and pots on the same day?

Sindu: Yes. But the pot sellers had a tie-up with the seed vendors. So, I got seeds with all the pots I purchased. I also got a few seeds for free.

Bindu: Good for you. This is similar to the cashless benefit in insurance.

Sindu: How so?

Bindu: Well, take motor insurance for instance. You get cashless garage service for the premium you pay. You can get the insured vehicle repaired at the issuer’s network garages without having to pay for it. Network garages are those that the insurance companies have tied up with to provide cashless services to their policyholders. You can check the list of garages with their name, address and contact number in your policy document or on the insurer’s website.

Sindu: How does this help? We get garage services anyway from the car company or the authorised dealer.

Bindu: Yes. But when your vehicle is damaged due to an accident, you can approach any of the network garages for cashless service. That is, once the repair work is done, the garage service provider will issue an invoice to the insurer directly who will bear the expense. The authorised dealer, you mentioned, could very well be part of your insurer’s network or not.

Sindu: That’s a great service. So, how do I go about it if my vehicle is damaged?

Bindu: The first step is to inform the insurer about the damage. Post the intimation, the insurer inspects the vehicle. Then a request for cashless service is initiated. Once the request is approved, the insurer takes care of all the expenses on repairing your vehicle. Some insurers also offer to tow your vehicle to the network garages!

Sindu: This is a huge relief!

Bindu: But remember, the insurance company will pay only for those damages that are covered under the policy. If parts of the car, such as the interiors including speakers and radio which are usually beyond the policy coverage, suffer damage, then you will have to bear the expense.

Sindu: Any downsides?

Bindu: Cashless garage is a huge advantage, especially when repair work has to be done and you are short of funds. However, this service may not be available across all cities or regions. Also, if you go to a garage which has no tie-up with your insurer, then you will have to pay for the repair work and get reimbursed from your insurer.

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