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Mon, Jul 12 03:08 PM





The Insurance Regulatory and Development Authority of India (IRDA) on Sunday
said it has decided to examine the issue of insurance companies withdrawing
the cashless facility for hospitalisation of patients to mediclaim policy
holders.

IRDA chairman Hari Narayan told Mail Today that 'appropriate action' would
be taken in the matter after discussing the issue with the concerned
stakeholders.

"Let us examine the issue. We are gathering the background information from
the insurers. We would then take appropriate action," J Hari Narayan told
Mail Today on phone from IRDA's headquarters at Hyderabad. Asked whether
there had been a breach of trust between the mediclaim policy holders and
the insurers, he replied, "Let me first get into the issue. It would be too
early to make any statement. The issue is being examined by us."

The move by insurance companies to withdraw the facility of cashless
hospitalisation has left the middle-class in a lurch.

At least 18 insurance companies, including public sector entities, have
withdrawn the cashless mediclaim policy facility and stopped direct payment
of treatment charges to high-end hospitals in Delhi, NCR and at other metros
like Mumbai, Bangalore, Kolkata and Chennai from July 1.

The policy holders are fuming. They feel cheated. "It's a breach of trust. I
availed the mediclaim policy for a year and paid Rs 30,000 for my family
members where they offered me cashless hospitalisation. How can they
write-off the agreed contract," says Rajesh Kumar, a resident of North
Delhi.

At least 100 hospitals in Delhi and NCR, besides other metros, have been
taken off the designated list of hospitals eligible to extend the cashless
facility of treatment. These hospitals include high-end ones like Max or
Medicity, Apollo, Fortis, Ganga Ram and other big hospital chains in Delhi
and NCR. Mediclaim policy holders who want to avail the facilities at these
hospitals, will now have to pay. They can then claim the amount from the
insurer with no guarantee that the entire amount would be reimbursed.

Taking serious note of the issue Delhi Chief Minister Sheila Dikshit on
Sunday said the state government would take every possible step to ensure
that people are not held to ransom in the fight between hospitals and
insurance firms.

She promised to look into the issue. "We will hold talks within a week and
try to find a solution to the problem," she said.

Terming it as a serious issue, Delhi health minister Kiran Walia said, "We
are really concerned as we know the impact. We cannot allow somebody to hold
the patients to ransom in the fight (between insurers and hospitals)," said
the health minister.

Industry bodies too have reacted sharply to the development. The chairman of
the Federation of Indian Chambers for Commerce and Industry (Ficci) health
services committee, Anjan Bose, termed it a retrograde move.

" This will put the policy holders, particularly the middle class patients,
who do not have ready cash available with them at a disadvantage. Such a
step will have adverse impact on the penetration of the health insurance
market in India," Bose said.

Insurance companies have been providing cashless services at over 3,000
hospitals across the country. Dr KK Aggarwal, president of the Heart Care
Foundation of India, said the cap on charges for particular treatment by
insurance agencies is a right move. "But why should the policy holders
suffer," he said.

Reproduced From Mail Today. Copyright 2010. All rights reserved.


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