IRDAI says hospitals to provide cashless treatments to patients, including for Covid-19

In a press release on Thursday, the Insurance Regulatory and Development Authority of India (IRDAI) said all hospitals, which have signed Service Legal Agreements (SLA) with general and health insurers, have to ‘mandatorily’ provide cashless facility for any treatment to the policyholders.

The Insurance Regulatory and Development Authority of India (IRDAI) clarified on Thursday that hospitals are obligated to provide cashless treatment, including for the coronavirus disease (Covid-19), if patients are entitled for it under their insurance policy.

Health workers seen in PPE kits outside Covid-19 ward, at Ganga Ram Hospital, in New Delhi. (Sanchit Khanna/HT PHOTO)

“There are some reports that hospitals are not granting cashless facility for treatment of Covid-19 despite policyholders being entitled for the cashless treatment under their Policy. In this regard, it is clarified that where insurers have an arrangement with the hospitals for providing cashless facility, such network hospitals are obligated to provide cashless treatment for all treatments including treatment for Covid-19,” IRDAI noted in a statement on Thursday.

All the network providers (hospitals), who have signed Service Legal Agreements (SLA) with general and health insurers, have to “mandatorily” provide cashless facility for any treatment to the policyholders, including for Covid-19, the regulatory body noted further.

In the event of being denied cashless treatment, the aggrieved policyholders, IRDAI said, can send a complaint to the concerned insurance company. In the release, it also provided details and email addresses of Grievance redressal officers of insurance companies.

“Insurance companies have also been directed to ensure smooth availability of cashless facility with all network providers,” IRDAI added.

India is currently in the grip of a second wave of the Covid-19 pandemic during which it is seeing more daily cases than it did during last year’s first wave. The country reported more than 100,000 fresh infections for the first time on April 5, topped 200,000 on April 15 and, on Thursday, the Union ministry of health family welfare (MoHFW) said there were 314,835 new cases in the last 24 hours, the highest single-day rise anywhere since the beginning of the pandemic in early 2020.

There were also 2104 related deaths in the 24-hour period (till Thursday morning), a record for a single-day.