Many medical insurance holders are going through difficulties in getting admissions to panel hospitals for cashless treatment amid a rising variety of Covid-19 instances throughout the nation.
If you’re going through the same situation, then you can file a criticism against hospitals if they refuse to give you cashless treatment. However, it’s suggested that you ought to first seek the advice of along with your Third-Party Administrator (TPA) to get cashless admission within the community hospital.
However, if the hospital nonetheless denies admitting you or your affected person on a cashless scheme, then you can file a proper criticism against the hospital. Here’s how you can both complain to your insurer or IRDAI.
1. You can begin submitting your criticism with the assistance of the insurer’s Grievance Redressal Mechanism. The insurer wants to absolutely attend to the criticism inside 15 days of registration.
2. In case, you’re not happy with the response, you can go for the Integrated Grievance Management System (IGMS) choice for escalating the criticism to IRDAI. IGMS facility permits policyholders to register their complaints and helps in its monitoring as effectively.
3. To file a criticism, you want to go to the official IGMS portal: https://igms.irda.gov.in
4. You now want to register your self by sharing data comparable to title, gender, date of start, and your tackle, if you are a primary time person. Otherwise, you can log in utilizing your credentials.
5. After producing your credentials you want to log in to the portal and click on on register criticism to file your criticism against the hospital/insurer.
6. You may also register your criticism through e mail by sending a mail to complaints@irdai.gov.in or calling on Toll-Free No. 155255 or 1800 4254 732.
Moreover, IRDAI has directed all insurers to stay in contact with hospitals in order that its prospects don’t face points in claiming cashless treatment. “Insurers are advised to put in place an effective communication channel with all the network providers for prompt resolution of grievances of policyholders. Insurers are advised to report levying of excess charges or denial of the cashless facility to the respective State Governments for appropriate action,” it says.
Taking be aware of the scenario, the Insurance Regulatory and Development Authority (IRDAI) has mentioned, “There are reports of certain network providers (hospitals) charging high rates and insisting on cash payments from the policyholders for providing treatment to COVID-19 infected patients despite having a cashless arrangement with Insurers”.
#mute
