>From Yahoo News: IRDA to probe insurers axing cashless mediclaim 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 At least 18 insurance companies, including public sector entities, have withdrawn the cashless mediclaim policy facility and stopped direct payment of treatment charges to high-end hospitals in Delhi, NCR and at other metros like Mumbai,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
