State-owned insurance companies on Tuesday agreed to restore cashless treatment facilities in big private hospitals on a case-to-case basis, a development likely to benefit mediclaim policy holders. “Insurance companies have decided to restore cashless facilities on a case-to-case basis. We discussed ways of making people part of the facility and how reimbursements can be revived,” said Sanjay Datta, head, health insurance, ICICI Lombard, after a Confederation of Indian Industry (CII)-initiated meeting between insurers and the healthcare industry.

State-owned insurance companies — Oriental Insurance, New India Assurance, National Insurance and United Insurance — have also agreed to expand the network of hospitals providing cashless treatment facility (PPN or preferred provider network) for the benefit of mediclaim policy holders.

The CII called a meeting of insurers and healthcare industry representatives to resolve the impasse following withdrawal of cashless treatment facility at 150 hospitals by the four PSU insurance firms from July 1 on allegations of over-billing.

“In order to keep health insurance premiums affordable and viable, all stakeholders, including consumers have to respect and maintain the integrity of the system,” said M. Ramadoss, CMD, New India Assurance.

The meeting was attended by representatives of Fortis, Max Healthcare, Apollo Hospitals.

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  1. Ramakrishnan Gangadharan says:

    If the CMD of New India Assurance really means what he says, let him
    visit pay surprise visits to his offices and get to know personally the % of staff present,
    the time they spend in their seats (i don’t mean work) and their rontribution to the company daily compared to their remunerations. He will be shell
    shocked and if he has the will to really help the consumer, will immediately scrap the TPA arrangements and will insist it should be done by his own staff.
    This will really heop the consumer directly and also reduce the nexus between the high flying and highest billing luxury hospitals and the Insurance companies.

  2. Nani Reporter says:

    Shri Ramadoss should first examine the proceedures and practices followed in the branches of his own company with regard to their violations of integrity of the system and respect for the consumers before preaching to others. Unfortunately the voice of individual customers do not reach the top echelons of such institutions who,it would appear, are prone to “Orwellian Thinking”.

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