are some reports that some hospitals are not granting cashless facility for
treatment of Covid-19 despite policyholders being entitled for the cashless
treatment under their Policy. In this regard, it is clarified that where
insurers have an arrangement with the hospitals for providing cashless
facility, such network hospitals are obligated to provide cashless treatment
for all treatments including treatment for COVID-19.
the Network Providers (hospitals) who havesigned Service Level Agreements (SLA)
with general and health insurers have to mandatorily provide cashless facility
for any treatment to the policyholders including Covid-19 treatment in
accordance with agreed provisions of SLA and terms and conditions of policy
all policyholders that are entitled to cashless facility at all such network
providers (hospital) with whom the Insurance company/TPA has entered into an
agreement shall avail the benefit of cashless treatment.
the event of denial of cashless facility at any such enlisted network providers
(hospitals) the aggrieved policyholders may send a complaint to the concerned
insurance company. The details and email ids of Grievance redressal officers of
insurance companies can be accessed from the website of the insurers or at the
companies have also been directed to ensure smooth availability of cashless
facility with all the network providers (hospitals) empaneled with them by
actively interacting with the hospitals.