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Taking a serious note of reports of denial of cashless treatment for eligible Covid-19 patients, the insurance regulator said cashless treatment facility cannot be denied.
“It is clarified that the policyholders are entitled to cashless facility at all such network providers (hospitals) with whom the insurance company/TPA (third party administrator) has entered into an agreement in accordance to the norms of service level agreement (SLA),” the Insurance Regulatory and Development Authority of India (IRDAI) said in a circular.
A list of network providers shall be published on the website of all general and standalone insurance companies. All these hospitals shall provide cashless claims facilities for all treatments, including Covid-19, it said.
In case of denial of cashless facility, policyholders can file a complaint with the insurer. The insurers have also been directed to put in place an exclusive grievance redressal mechanism to address complaints relating to the denial of cashless claims.
Corona Kavach
The insurers will provide a 5 per cent discount in the premium to doctors, nurses and other health workers in the standard Covid-19 insurance policy, Corona Kavach .
“As a gesture of acknowledgement of the contribution of the healthcare sector in nation’s fight with Covid-19, the insurance companies will provide a 5 per cent discount in the premium of Corona Kavach to doctors, nurses and other healthcare workers in terms of the guidelines issued by IRDAI,’’ the insurance regulator said in a release.
As mandated by the regulator, all 30 general and health insurers have started offering individual specific standard policy covering Covid-19 treatment.
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