The Insurance Regulatory and Development Authority of India (IRDAI) is teaming up with industry stakeholders to roll out two significant improvements in health insurance policies, reports The Economic Times. These enhancements encompass the creation of a unified hospital network that will be accessible for all health insurance policies nationwide, regardless of the provider, and the introduction of a fully cashless settlement system that covers all expenses.
Currently, cashless settlement services are available in only 49 percent of hospitals across India. To address this and combat fraudulent claims and escalating medical costs, both general and health insurance companies frequently update their lists of affiliated hospitals. To tackle these challenges, the insurance regulator is collaborating with the General Insurance Council (GIC) to establish a common cashless hospital network nationwide, aimed at expanding and streamlining the health insurance claims settlement process.
Industry insiders revealed that the General Insurance Council has already set up a committee with the objective of creating a shared hospital empanelment system. The committee is also working on setting a standardized onboarding rate for hospitals by insurers, replacing the current system in which different hospitals and insurance companies have separate agreements with varying rates.
In addition to creating a common cashless network accessible to all insurance providers, the regulatory authority is also gearing up to introduce a 100 percent cashless health insurance claim settlement system. Negative claim experiences have often deterred potential buyers from investing in health insurance policies due to concerns about their reliability. Substantial improvements in this area could help rebuild trust among policyholders and ensure equal access to hospitals, regardless of the insurance provider. This would foster greater trust and boost insurance adoption nationwide.
The initiative’s initial phase is progressing smoothly, with the possibility of implementation by January 1, 2024, as details are being finalized by the Council, according to Parthanil Ghosh, President of Retail Business at HDFC ERGO General Insurance.
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