The Insurance Regulatory and Development Authority (Irda) on Friday washed its hands off the impasse over cashless mediclaim facility between some major hospital chains and insurance companies and said the authority’s role was limited to being an overseer of a contract.
The ongoing row over withdrawal of cashless facility in some of the major hospitals is not a regulatory issue but a commercial one, Irda chairman J Hari Narayan said.
He ruled out any immediate regulatory intervention saying a cashless mediclaim is a commercial transaction, which will require intervention if there is contractual violation only. “I maintain it is not a regulatory issue, if there is a violation of contract it will be the utmost priority of IRDA to uphold the contract,” he said. As on June 30, 391 hospitals offered cashless mediclaim facility.
This month, state-owned insurance companies removed about 150 hospitals from the list of Preferred Provider Network that offers cashless hospitalisation service to their policy-holders under mediclaim scheme.
State-owned insurers—New India Assurance, United India Insurance, National Insurance and Oriental Insurance—stopped the service due to alleged over-billing by some private hospitals.
Insurance companies would be holding an official interaction over the issue with private hospitals later today, Narayan said.
However, he did not say if the regulator would intervene in the row, going forward.
“We can only fine these insurance companies up to Rs 500,000 if they violate the contract with these hospitals,” he said. Meanwhile, he said the listing norms for life insurers were expected shortly and for non-life insurance companies, the likely release of these guidelines would take up to two months.
NewsWire18
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