Flagging complaints of insured COVID-19 patients being denied cashless treatment by hospitals, a body of general insurance agents has urged the Insurance Regulatory and Development Authority of India (IRDAI) to take up the matter with State and Central Health Ministries.
Alleging that the corporate hospitals were also demanding cash settlement of the bills, the General Insurance Agents’ Federation Integrated (GIAFI) said “depending on the severity of the patient’s condition, they are asking for huge sums as advance”.
This was resulting in policyholders losing confidence in the insurance system and the companies. The agents were also at the receiving end with some of their customers getting into arguments “as if the [premium] amount is personally taken by them”, Federation president Rapolu Sudhakar wrote to the IRDAI, with copies of the letter marked to the Prime Minister, the Union Finance and the Health Ministers, the Telangana Chief Minister, insurance companies and the General Insurance Council.
Welcoming a recent direction of the IRDAI asking health insurers to initiate action against hospitals refusing cashless facility, the agents body said the regulator should escalate the matter to arrive at an amicable solution.
Guideline rates
The general insurance company managements were helpless, he said, asking “what action the companies can take on mass defaulters in this pandemic situation?” The State governments and the General Insurance Council had already issued guideline rates to be charged by hospitals.
The Federation said the authorities should insist on private hospitals releasing daily bulletin on the availability of beds, admission data and cashless insurance details. Non-compliance must be viewed seriously by the government. Mr. Sudhakar said there was also need to revise tariff according to the city and class of hospitals in consultation with the hospital management associations and other authorities.
