CASHLESS INSURANCE
Why can your insurance claim get rejected & how to avoid it?
All health insurance policies have a life-long renewal clause which the regulator has mandated. They cannot be rejected and your pricing cannot go up purely because you have a condition right now. So, certain benefits are inbuilt and benefits that the customer can take, says Deepak Yohannan, CEO, MIC Insurance Web Aggregator
Star Health aims to double Gross Written Premium to Rs 30,000 cr in 4 yrs: MD
Star Health and Allied Insurance Company Ltd. has set a target to double its Gross Written Premium to about Rs 30,000 crore over the next four years. The company, based in Chennai, has recorded a profit after tax of Rs 845 crore, a 37% increase from the previous financial year. The company has approved claims of about Rs 44,000 crore since its inception in 2006.
Health insurer Niva Bupa, Sagility India files draft papers with Sebi for IPOs
The IPO, with each share having a face value of Rs 10, consists of a fresh issuance worth Rs 800 crore and an offer for sale totaling up to Rs 2,200 crore by the promoters and existing investors. As part of the OFS, Bupa Singapore Holdings and Fettle Tone will be divesting their stakes.
6 health insurance claim rule changes in 2024
Previously, if you were hospitalized at a non-network facility, you were unable to use the cashless claim service and had to pay upfront, then seek reimbursement after discharge. Now, you can access cashless claims regardless of the hospital you are admitted to. (Text by Riju Mehta/ET Bureau)
Nearly 70% health claim users opting for reimbursement mode don't have enough liquid savings to pay bills: Survey
A recent study highlighted challenges faced by health insurance policyholders opting for reimbursement, often resorting to borrowing or dipping into savings for medical bills. Despite expanded coverage, 68% lacked adequate savings for expenses. Cashless treatment remains preferred, with 89% satisfaction, compared to 79% for reimbursements. Delays post-discharge also impact satisfaction.
Is your medical claim stuck? Find out why you face problems in health insurance claim settlement and how to avoid them
While health insurers can sometimes be blamed putting customers through unending hardship in clearing claims, many a times it’s the policyholder who is at fault. A significant portion of these health insurance claim rejections can be prevented by asking the right questions during policy selection, carefully reviewing policy documents, and conducting thorough research. This article explores common health insurance claim rejection scenarios and explains how to avoid them.
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6 recent health insurance claim rule changes every policyholder should know
Insurers will have to clear a health insurance claim within three hours of receiving it from the hospital during discharge. Irdai has also given a window of one hour for clearing cashless claim requests at the time of admission. All you need to know about the recent health insurance claim norm changes by the insurance regulator.
Star Health looking to grow 18%, improve claims ratio by 50 bps: Anand Roy, CEO
Star Health & Allied Insurance expects 18-20% growth in gross written premiums this year, aiming to double premium income in four years. CEO Anand Roy discussed the company's strategies with Shilpy Sinha.
Travel Insurance: What you need to know before you plan your next international trip
Travel insurance provides coverage for travel risks, including medical support, flight cancellations, and emergency evacuation. It is not always mandatory but advisable for international travel. Policies include trip-wise insurance and group travel insurance.
Insurers must offer a basic cover, strict claim deadlines
Regulator mandates 'pay as you drive' option in motor insurance. Customers to benefit from tailored products and roadside assistance services. Insurers bear salvage disposal burden, offer flexible 'fire' policy options.
All insurers must offer basic cover, meet settlement deadlines: IRDAI
IRDAI announced customer-centric measures, requiring general insurance companies to offer basic insurance products with clear coverage details on their websites for easy comparison and customization.
General insurance companies can't reject claims for want of documents: Irdai
Irdai stated that general insurance companies cannot reject claims for lack of documents, introducing reforms in the business with a new master circular, repealing 13 others.
Is travel insurance mandatory for Schengen Visa applications?
Understanding visa requirements is crucial when planning a trip to Europe. To visit any of the 27 countries in the Schengen Area, a Schengen visa is mandatory, requiring financial stability and travel insurance for Indian citizens.
NHCX, a single portal for all health insurance claims soon: what is the claims process, benefits to policyholders
The digital platform, to be launched in 2-3 months, will speed up and standardise claim settlement process, leading to cost benefits for the insured.
Cashless claims to be cleared in 3 hours
Irdai has also mandated the insurer to decide on the cashless authorisation within one hour of receipt of the request.
Why has Quant Large Cap fund been an outperformer? Shweta Rajani answers
I will highlight two-three points over here. One is definitely a size advantage that a Quant would have, so I am talking about a thousand crore fund versus a 35,000 crore fund, so that helps in the agility of the fund manager to actively manage.
Improvement in tech, backend processes & team strength needed to achieve IRDA objective: Shweta Rajani
It is welcoming move what IRDA has done because it now means that one within three hours in a normal case the insurance company has to authorize the entire documentation and the claim approval has to go through, not only that they are also emphasising that there should be a 100% claim and any claim rejection by the insurance company would internally need internal explanations and approvals.
Health insurance claim rule change: Cashless claims must be cleared in 3 hours; insurer to pay hospital charges for delay in discharge, says IRDAI
Health insurance: The Insurance Regulatory and Development Authority of India (IRDAI) has released a master circular to streamline health insurance claim process. Previously, delays in claim approvals forced patients to stay in hospitals longer. Now, insurers have three hours to approve cashless discharge requests. Additionally, insurers will be liable for extra hospital charges due to delays.
IRDAI in favour of 100% cashless claim settlement in health
In terms of cashless claims, the regulator wants insurers to decide on authorisation requests within one hour of receipt. It has directed insurance companies to put in place necessary systems and procedures to meet the new guidelines by July 31, 2024.
No more out-of-pocket expenses: The impact of 'Cashless Everywhere' on health insurance
The 'Cashless Everywhere' initiative by the General Insurance Council and insurers like Bajaj Allianz aims to provide hassle-free access to quality healthcare at any hospital, reducing financial burdens and ensuring prompt medical assistance for policyholders.
SAHI jawab for insurance
India's insurance industry is experiencing a significant transformation, primarily driven by the growth of health insurance. The Insurance Regulatory and Development Authority of India (Irdai) has shifted its focus from rule-based to principle-based regulations, aiming to achieve universal insurance coverage by 2047.
Invest, and use market as medicine
The low investment in health has led to a demand-supply gap, which private sector has been closing. While this means choice, better medical services and more jobs, it has also led to anomalous pricing of procedures and high out-of-pocket expenditures, making implementation of a cashless health insurance system difficult.
Cashless health insurance at all hospitals now but network hospitals are still better option for ‘assured’ cashless treatments
On paper, cashless everywhere is a great initiative as it aims to reduce out-of-pocket expenses of policyholders for medical treatments. However, health insurance policyholders need to keep a couple of things in mind before opting for a cashless everywhere facility at any hospital. You need to understand if you go to a non-empanelled hospital, how it will charge you for the treatment. Read here to know more
Soon, road accident victims may get free cashless treatment up to Rs 1.5 lakh at hospitals across the country
The Ministry of Road Transport has approved a proposal to provide free cashless treatment to victims of road crashes. Under this scheme, victims will receive medical care at Ayushman Bharat-empanelled hospitals with an upper limit of Rs 1.5 lakh for up to 10 days of hospitalization. Insurance companies will bear the cost. The initiative aims to provide timely medical assistance within the 'golden hour' and reduce road fatalities.
Health insurance rule change: Cashless treatment at any hospital from today; how to get it, charges
Till now, a health insurance policyholder can get cashless treatment only at network hospitals with whom the insurance company has tied up. If it is a non-network hospital, the policyholder has to pay the entire amount from his pocket and then go through the cumbersome claim reimbursement process. The General Insurance Council in consultation with general and health insurance companies has launched 'Cashless Everywhere' to extend the cashless treatment at all hospitals. What is the new rule? How to get cashless treatment at any hospital? Know here
Health insurance: Cashless treatment at any hospital now as insurers launch new initiative
The General Insurance Council has introduced an initiative, 'Cashless Everywhere', to facilitate cashless hospitalization for policyholders even in non-empanelled hospitals. Hospitals with 15 beds, registered under the Clinical Establishment Act, can provide cashless hospitalization.
Health insurance claim reform: Cashless treatment at any hospital may be a reality next year; how it will help
Till now, a health insurance policyholder can avail of cashless treatment only at network hospitals with whom the insurance company has tied up. Each insurance company has an independent network of medical service providers that they have a tie-up with. The insurance regulator, along with the General Insurance Council (GIC) has proposed to introduce a 100% cashless network that will include both empanelled and non-empanelled hospitals.
Health insurance new features: Common cashless network across the country, 100% cashless system to be launched soon
IRDAI is planning to introduce two new features in the health insurance policy — a common network for hospitals for all health insurance policies issued by any health insurance or general insurance company across the country and a 100% cashless settlement system. These two initiatives will help insurers to provide an integrated and comprehensive cashless hospital network to customers to ensure that their claims experience is seamless and hassle-free. Read on to find out more about it.
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