IRDAI: Insurers should decide to take action against hospitals denying cashless service

An insurance company can take action against a hospital for demanding advance from a policy holder who is supposed to get cashless service, an official of insurance regulator IRDA said. In a recent circular, Insurance Regulatory and Development Authority (IRDA) has put the onus of taking steps against medical establishments for deficiency in service on the insurer, the official said.
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 official told. “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,” the circular said. One of such “appropriate” actions is blacklisting the erring hospital, a senior official of an insurance firm said.