INSURANCE
Insurance company can take action against hospital denying cashless service: IRDAI
Aug-17-2020

Insurance Regulatory and Development Authority of India (IRDAI) has said that an insurance company can take action against a hospital for demanding advance from a policy holder who is supposed to get cashless service.

It has put the onus of taking steps against medical establishments for deficiency in service on the insurer. There has been a sharp spike in complaints post COVID-19 outbreak that private hospitals are demanding huge advance before admission even from patients having cashless medical insurance. In the wake of such complaints, IRDA issued the circular on cashless service to policy holders by hospitals.

The regulator said ‘where any network provider (hospital) denies cashless facility and deviates from agreed terms of the SLA (service level agreement), insurance company shall take an appropriate action against such network providers’.

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