Thursday, June 13, 2024

According to the new rules, 'Cashless' is now allowed immediately


Aparna Deokar (Insurance)

Health insurance holders will get benefit from the new notification of the insurance regulatory body 'IRDA'. At present, insurance companies take a long time to accept requests for cashless treatment. But according to the new rules, cashless treatment will have to be allowed within an hour. Therefore, the insured patient or the family members of the insured do not have to rush and collect money.

There is good news for health insurers. If a policyholder requests permission for cashless treatment, the insurance company has to approve it within an hour. Insurance regulatory body 'IRDAI' has issued a notification in this regard. This notification explains the cashless approval process. On May 29, Irsh issued a circular. This master circular will automatically supersede the previous 55 circulars.

What is the current status?

Insurance companies usually approve some amount immediately after receiving the cashless reimbursement from the hospital. Of course, the final settlement of the mediclaim takes place at the time of discharge. At this time the insurance company receives the hospital bill and other documents. Also, cashless auspices and claim settlement require finger approval from insurance company and only then the further process takes place. It takes a lot of time.

The option has to be paid before increasing the sum assured

Generally insurance companies increase the Sum Insured in return for no claims from the policyholders. They do not charge separately for this. Now 'Idaan' has asked the insurance companies to give two options to the policy holders. Firstly, the policyholder can opt to carry the room insurance amount and secondly, if the Sum Hunsturd Swakam is not voluntary, then the renewal premium can be discounted in return. Those policy holders who have to pay extra premium due to Corona can get relief.

The policy can be canceled at any time

Now policy holders can cancel their health insurance policy at any time. For this, the insurance company has to send a notice of three days, this rule is applicable to the policyholders who take the policy for one year. If the policy is canceled within one month, the insurance company is obliged to return the advance amount burned as installments to the policyholder for the remaining period of 11 months.

Option of renewal of withdrawn products

Insurance companies are withdrawing insurance policies or rolling them into new products based on their experience. Especially policy holders with older policies may experience this. According to the insurance company, the change in the policy structure is taken in the interest of the insured. As a result, the policyholder's premium increases. Irda has not yet taken steps to address this issue. But if the renewal period of the policy falls within the three-month withdrawal period, the insurance company can offer the policyholder an opportunity to renew.

Penalty for not complying with the order of 'Ombudsman'

Insurance companies will have to comply with the order of the Insurance Ombudsman within thirty days. Viga Company will have to pay a penalty if such action is not taken. According to this, the company will have to pay two annas more than the current rate of interest on the payment mount. IDA said that if the order of the ombudsman is not followed, the insurance company will have to pay five thousand rupees per day to the policy holder.

What does IRDA notification say?

Yes has asked insurance companies to approve within one hour of receipt of chill for final cashless agharisation. The notification states that in case the valuation takes more than one to three hours, the payment of additional amount (if any) will be levied to the insurance company from the shareholder's fund. If the policyholder dies during the course of treatment, Bina Company and Runalwa will have to allow immediate handover of the dead body to the next of kin. Insurance companies will have to make full preparations by July 31 to implement this new rule.

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