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Good news for health insurance policyholders: Check new guidelines, how to get it

General and health insurance companies launched the "Cashless Everywhere" initiative in partnership with the General Insurance Council.

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There's a new change in the Indian medical industry. People can now pay for their medical care at any hospital in the country with cashless options. This follows the decision made by general and health insurance companies to provide medical insurance policyholders with 100% cashless treatment starting on Thursday, January 25.

General and health insurance companies launched the "Cashless Everywhere" initiative in partnership with the General Insurance Council, the highest authority for general insurers.

What's the current guidelines?

With a cashless facility, policyholders are not required to pay for hospital treatment under the terms of their current health insurance policies. Instead, insurance companies agree to pay for hospital treatment as long as the claim is accepted.

There are only a few hospitals that offer this cashless service due to agreements or partnerships with the individual insurance company. The policyholder will not be able to access this facility, though, if he selects a different hospital without a signed agreement. In that scenario, the client will need to file a reimbursement claim, which will cause the claim procedure to be further delayed.

About the new medical policy guidelines

However, under the new programme, policyholders can receive care at any hospital—regardless of whether the facility is part of the insurance company's network—for free. According to Indian Express, it enables the policyholder to be admitted to any hospital of their choice without having to pay a deposit up front, with insurance companies paying the balance on the day of discharge.

According to this, the policyholder must notify the insurance provider at least 48 hours in advance of admission. If the policyholder needs emergency care, they have 48 hours from the time of admission to notify the insurance company.

According to the General Insurance Council,“The claim should be admissible as per the terms of the policy and the cashless facility should be admissible as per the operating guidelines of the insurance company."

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