State insurers to restore cashless mediclaim in a month

The four state-owned non-life insurance companies have agreed to restore the cashless mediclaim facility in another 30 days by forming a group package for each corporate hospital, bringing relief to holders of such policies.

“We have to work out the methodology. We will do that in less than 30 days,” said M Ramadoss, chairman and managing director of New India Assurance. He said patients requiring emergency and trauma services would be attended by all hospitals through a cashless scheme in all third-party administrator-empanelled hospitals.

The group package would differ with hospitals. The four PSU companies will follow the same rules for each corporate package. The decision was taken at a meeting between the healthcare industry and the PSU non-life insurers called by the Confederation of Indian Industry (CII). Apollo Hospitals, Max and Fortis Healthcare representatives attended the meeting.

“We have decided to add the remaining PPN (preferred provider of network) in another 30 days. This will require a few more meetings with the hospitals. We have to work out the structure for corporate hospitals. They have appreciated our position and there is the general recognition that health insurance is not producing good results,” said G Srinivasan, chairman and managing director of United India Insurance.

A committee of the hospitals and the insurance companies had been formed to find a long-term solution to the issue, said Naresh Trehan, chairman of CII’s healthcare committee. Pervez Ahmed, managing director of Max Healthcare, and Pavan Bhalla, chief executive officer of Raksha TPA (Third Party Administrator), are the coordinators of the committee. “The committee will try to come out with a solution within 10 working days,” Trehan said.

Irda for pricing standards
Meanwhile, Insurance Regulatory and Development Authority (Irda) Chairman J Hari Narayan ruled out intervention in the cashless service issue between PSU insurance firms and some corporate hospitals.

Narayan also said Irda had written to the Union health ministry to prepare standard operating procedures for hospitals to bring some uniformity in pricing. State-owned players had made a new list of hospitals from July 1.