August 09, 2010

Insurers, hospitals to restore emergency cashless claims

State-owned insurers and corporate hospitals agreed on Friday to restore with immediate effect cashless medical claims for treatment of emergency cases, but left a solution to their month-long standoff over remaining settlements hanging.

“Treatment for cardiac surgery, intensive care and trauma has been restored immediately,” said Dr Naresh Trehan, who represented hospital chains at a meeting between the two sides in New Delhi on Friday.

Dr Trehan said the dispute would be fully resolved within “10 working days”, though he added that reaching a solution could stretch up to a month.

The development will provide some relief to consumers, who were bearing the brunt of a decision by New India Assurance, Oriental Insurance, United India Insurance and National Insurance Company to stop cashless insurance reimbursements in a few big hospitals on July 1. The insurers alleged that the hospitals were overcharging consumers, pushing their business into losses.

Consumers who took health cover to avail cashless treatment had little option, but pay for hospitalisation. Up to 5% of India’s 1.2-billion population is estimated to be covered by mediclaim policies.

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