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Saturday, September 3, 2011

Health insurers must update customers about list of hospitals

New Delhi: Health insurers offering cashless facility have been directed to keep their customers updated about any change in the list of hospitals as well as about alternative options in the vicinity, Parliament was informed on Friday.

Citing an IRDA report for 2008-09 and 2009-10, Minister of State for Finance Namo Narain Meena in a written reply informed the Lok Sabha that cashless basis of settlement is costing more for all type of diseases.

He was replying to a query whether the cashless health insurance facility was being misused by hospitals.

Meena further said to ensure that interest of policy holders is not adversely affected when the insurers make changes in their partner network of hospitals, directions have been issued to them.

"...It has directed all insurers... to inform the policyholders at all times, the nearest possible alternative hospitals, where the cashless facility is available and the conditions thereof," he added.

Insurance companies negotiate rates for certain medical procedures and normally include in the network only those hospitals, who have agreed to the rates.

Last year customers were left in a quandary following a deadlock between the four PSU insurers and major private hospitals over resumption of cashless facilities.

The four PSU insurers -- New India Assurance, United India Insurance, National Insurance and Oriental Insurance -- have suspended the cashless service at select hospitals from July 1, 2010, alleging over-billing by them.

Later on the Insurance Regulatory and Development Authority (IRDA) came out with a guideline asking insurers to constantly inform customers about the hospitals which offer cashless treatment.

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