IRDAI allows Insurance companies to empanel Hospitals for cashless facility

New Delhi: In a move to reduce the financial burden on insurers, the Insurance regulator IRDAI has allowed general insurers to choose network providers or hospitals that meet their standards, thus easing norms for expanding cashless facilities in the country.

The Insurance Regulatory and Development Authority of India (IRDAI) has modified the 'Guidelines on Standardisation in Health Insurance' to give effect to the new norms.

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"…in order to enhance the scope for offering cashless facility across the length and breadth of the country, the insurers are now empowered to empanel the network providers that meet the standards and benchmarks criteria as specified by their respective boards," it said in a circular to insurers and third-party administrators (TPAs).

Earlier, only those network providers which were registered in the Hospital Registry ROHINI maintained by Insurance Information Bureau (IIB) could be empanelled by the insurers.

Hospitals offering cashless services had to also meet the pre-accreditation entry-level standards laid down by National Accreditation Board for Hospitals (NABH).

"The regulator is steadily improving the ease of doing business. This circular allows insurers to take independent decisions on which hospital to empanel and then be transparent about that," said Kapil Mehta, co-founder, SecureNow.

IRDAI further said the boards of insurers should consider the minimum manpower and healthcare infrastructure facilities before empanelling a hospital.

The board-approved empanelment criteria should also be published on the website of the insurers from time to time, the circular said.

On the IRDAI's decision, Sharad Mathur, MD and CEO, of Universal Sompo General Insurance said the regulatory initiative would increase the scope of the insurers' cashless services which would play a pivotal role in reducing the financial burden on policyholders.

"This will also provide a strong network of health care plus insurance services countrywide," he said.

The regulator has also asked the insurers to focus on the delivery of quality healthcare services while taking on board hospitals for cashless facilities. 

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