CASHLESS CLAIMS: TRUST AT STAKE IN HEALTH INSURANCE

Cashless claim settlement is a key benefit in health insurance, especially when one is afflicted with a critical illness, or there is a situation warranting huge medical expenditure.

- VEGNAPRIYA BHARATH

The least an insurer and network provider or hospital can do is to ensure that patients and families are not burdened with financial worries when they are entitled to protection through their health insurance cover.

There may be individual situations where cashless claims are denied. For example, when a hospital has payments pending from an insurer, or when a particular insurer and hospital are sorting out their pre-agreed tariff rates. However, the recent trend of industry bodies and hospitals facing off under the veil of collective bargaining is distressing for policyholders.

Health insurance covers don’t come cheap, and when one cannot get cashless benefit, it further dilutes the trust factor, something that insurance as a financial protection mechanism is already struggling to overcome.

The regulatory framework for health insurance has been evolving to ensure that policyholders’ interests are always protected. Thanks to a regulatory push, the insurance industry is moving towards 100% cashless settlements. There are initiatives such as ‘Cashless Anywhere’ where the service is provided even where a hospital is not a network hospital that offers such services.