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Recently, The General Insurance Council launched the “Cashless Everywhere initiative in consultation with all the General and Health Insurance Companies.

Cashless Everywhere Initiative Revolutionizes Health Insurance

• Current Scenario: Presently, around 56% of health claims are settled through cashless routes. 
  • However, cashless facilities are restricted to network hospitals, posing challenges for policyholders in rural areas who may lack access.
• Boost Insurance Penetration: With the newly announced initiative GIC and the Insurance Regulatory and Development Authority of India (IRDAI) aims to root out the cashless facilities restricted to network hospitals, for the customers and boost insurance penetration in the country.

What is the Cashless Everywhere Initiative?

• Under ‘Cashless Everywhere’, the policyholder can get treated in any hospital of their choice, and a cashless facility will be available even if such a hospital is not in the network of the Insurance Company. 

Key Features of Cashless Everywhere Initiative 

• Expanded Coverage: Policyholders can avail of cashless treatment at any hospital of their choice, regardless of network affiliation.
• Hospital Eligibility: Hospitals with a minimum of 15 beds, registered under the state health authorities, can offer cashless hospitalisation.
• Enhanced Ecosystem: Up to 40,000 hospitals across India will be part of this cashless facility ecosystem.

Procedure

• Pre-Admission Notification: Policyholders must inform insurers at least 48 hours before elective procedures and within 48 hours of emergency admissions.
• Admissibility: Claims must comply with policy terms and insurer guidelines for cashless facility eligibility.

Technological Support

• The cashless system is backed by a robust technological platform facilitated by the National Health Authority.

Benefits of Cashless Everywhere Initiative 

• Convenience: Simplifies the claims process and eliminates paperwork associated with reimbursement.
• Fraud Reduction: Helps in curbing fraudulent claims and abuse, ensuring better cost management.
• Cost Management: Enables insurers to negotiate better tariffs with hospitals, contributing to premium stability and affordability.

News Source: The Indian Express