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Asking insurers to get the best and cost-effective services for health insurance claimants, regulator IRDAI has directed them to pass on discounts, if any given by hospitals, to policyholders.
In a circular to insurers and Third Party Administrators (TPAs), IRDAI said they may be obtaining discounts from various network providers and other hospitals outside the network during settlement of claims under health insurance policies.
“While every insurer and TPA shall endeavour to get the best and cost effective services to the policyholders or the claimants of health insurance policies, it shall be ensured that the discounts obtained from the hospitals, if any, are passed on to the policyholders or the claimants of the underlying health insurance policy,” it said.
It also asked them to put in place procedures including mandating the hospitals to reflect such agreed discounts in the final hospitalisation bill of each claim, whereby the policyholder or the claimant can also be aware of the actual bill raised by the hospital.
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