Sunday, June 23, 2024

IRDAI Demands 100% Cashless Health Insurance Settlement in All Hospitals, Seeks Report from Committee

New Delhi: Soon, holders of medical policies will avail themselves of a 100% cashless facility, allowing hospitals to treat patients without any upfront payments. Currently, hospitals create pressure on policyholders to deposit a certain amount upon admission for treatment, making it essential to pay an upfront sum. To implement a cashless settlement system in all hospitals, the Insurance Regulatory and Development Authority of India (IRDAI) has formed the General Insurance Council (GIC) and appointed Shekhar Sampat Kumar as the Health Insurance Director. He has been entrusted with the responsibility of implementing this system.

IRDAI has instructed a report to be submitted regarding the general panel process in hospitals and the complete implementation of 100% cashless medical insurance settlement across hospitals nationwide. Presently, the cashless settlement facility is available in 49% of hospitals, totaling around 25,000 establishments.

According to IRDAI, an estimated 400 million medical insurance policyholders will benefit from the scheme’s implementation. In light of recent conflicts between insurance companies and hospitals, IRDAI is seeking ways to resolve such occurrences.

As per a directive issued by the Secretary of the General Insurance Council (GIC), Indrajit Singh, on August 1, the committee will provide weekly updates until the nationwide cashless settlement begins by the end of October. Notably, the committee is chaired by S. Prakash, the former Managing Director of Star Health and Allied Insurance Company.

IRDAI has appointed Shekhar Sampat Kumar as the Health Insurance Director for GIC and the Insurance Ombudsman for a tenure of three years. He may assume office responsibilities in Chennai by the end of this month. Shekhar Sampat Kumar played a crucial role in standardizing medical procedures’ rates for PSU General Insurers a decade ago. Now, he will work towards bringing all hospitals under the cashless facility and applying general processing rates for them.

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