The Insurance Regulatory and Development Authority of India (IRDAI) is collaborating with industry stakeholders to implement two fresh enhancements in health insurance policies, according to The Economic Times. These enhancements include a unified network of hospitals accessible for all health insurance policies offered by any health insurance or general insurance provider nationwide, as well as the implementation of a fully cashless settlement system, covering all expenses, it said.
Currently, cashless settlement services are accessible in 49 percent of the hospitals in India. Both general and health insurance companies frequently update their roster of affiliated hospitals in response to costly medical bills and fraudulent claims aimed at maximising payouts from insurers. To address these dual challenges, the insurance regulator, in collaboration with the General Insurance Council (GIC), aims to establish a nationwide, industry-wide common cashless hospital network. This initiative aims to expand and streamline the health insurance claims settlement process, said the report.
The report, citing industry insiders, said the General Insurance Council has already formed a committee with the goal of creating a shared hospital empanelment system.
The committee is also in the process of devising a standardised onboarding rate for hospitals by insurers, as opposed to the current scenario in which different hospitals and insurance companies have separate agreements with varying rates, it added.
In addition to implementing a common cashless network accessible to all insurance providers, the regulatory authority is also preparing to introduce a 100 percent cashless health insurance claim settlement system, as per the report.
Frequent negative claim experiences in health insurance often dissuade potential buyers from investing in health insurance policies, as they question the reliability of such policies. Significant enhancements in this regard can help rebuild policyholders’ trust and confidence. This will also guarantee equal access to hospitals, regardless of the insurance provider, fostering greater trust and thereby increasing the adoption of insurance throughout the country, it said.
“The initial phase is progressing smoothly, and it is highly probable that they will be introduced by January 1, 2024, as the details are currently being finalised by the Council,” Parthanil Ghosh, President- Retail Business, HDFC ERGO General Insurance, was quoted as saying in the report.
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Updated: 23 Oct 2023, 07:37 PM IST