State-owned insurance companies to restore cashless treatment facilities (case to case basis) in big private Hospitals

State-owned insurance companies on Tuesday agreed to restore cashless treatment facilities in big private hospitals on a case-to-case basis, a development likely to benefit mediclaim policy holders. “Insurance companies have decided to restore cashless facilities on a case-to-case basis. We discussed ways of making people part of the facility and how reimbursements can be revived,” said Sanjay Datta, head, health insurance, ICICI Lombard, after a Confederation of Indian Industry (CII)-initiated meeting between insurers and the healthcare industry.

State-owned insurance companies — Oriental Insurance, New India Assurance, National Insurance and United Insurance — have also agreed to expand the network of hospitals providing cashless treatment facility (PPN or preferred provider network) for the benefit of mediclaim policy holders.

The CII called a meeting of insurers and healthcare industry representatives to resolve the impasse following withdrawal of cashless treatment facility at 150 hospitals by the four PSU insurance firms from July 1 on allegations of over-billing.

“In order to keep health insurance premiums affordable and viable, all stakeholders, including consumers have to respect and maintain the integrity of the system,” said M. Ramadoss, CMD, New India Assurance.

The meeting was attended by representatives of Fortis, Max Healthcare, Apollo Hospitals.

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