August 09, 2010

Delhi High Court pulls up IRDA over cashless treatment spat

The Delhi High Court has pulled up insurance regulator IRDA for its failure to sort out a dispute between insurance companies and city hospitals due to which people having medical insurance are facing difficulties in getting cashless treatment.

Justice S. Muralidhar asked the Insurance Regulatory and Development Authority to take immediate steps so that patients who are insured can get the facilities of cashless treatment.

“You cannot leave patients suffering saying that meeting will be convened. Patients are not getting treatment because of dispute between insurance company and hospitals. It is your duty to act timely,” Justice Muralidhar said.

The court took strong exception to the remarks of IRDA chairperson published in a newspaper in which he was quoted as saying that it is a matter between the insurance companies and the hospitals and there is no regulatory issue involved in it.

The court was hearing a petition filed by one Vishal Ahuja whose 53-year mother, a cancer patient, was refused cashless treatment in the Dharamshila Cancer Hospital and other medical centres.

Turning down his plea of cashless treatment, the hospital authorities said that because of dispute between insurance companies and hospitals regarding reimbursement of medical bills, the companies have decided to discontinue cashless facility for individual policy-holders.

Mr. Ahuja then approached the Delhi High Court contending that he had paid extra premium to Oriental Insurance Company to avail the cashless facility and IRDA should be directed to settle the dispute between the insurance companies and the hospitals as it would take more than a month for getting reimbursement for treatment from companies.

Link: Original Article

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