Experts term IRDAI’s new circular on cashless treatment excellent; see it as win-win decision for insurers and policyholders

Insurance Regulatory and Development Authority of India (IRDAI) on July 20, 2022, allowed general insurers to choose network providers or hospitals that meet their standards, thus easing norms for expanding cashless facilities in the country.

In this regard, several experts from the insurance sector quoted this as an excellent step. They pointed out that this move will increase the scope of the insurer’s cashless service and play important role in cutting the financial burden on policyholders.

We have collated views from different experts on the new circular of IRDAI on cashless treatment:

Expert: Rahul Sharma, President – Claims, Liberty General Insurance

This move from IRDA is commendable! While the urban areas have a large network of cashless hospitals, going forward the guidelines would push insurers to expand services to rural areas as well and it will largely reduce the financial burden among policyholders and provide ease while opting for the cashless facility at hospitals.

The Insurance regulator has modified the 'Guidelines on Standardisation in Health Insurance' to give effect to the new norms.

This move also gives responsibility to insurer(s) to standardize and benchmark the empanelment criterion in a hyper-competitive mediclaim market where the focus on quality of providers will be further enhanced.

Expert: Sharad Mathur, MD & CEO, Universal Sompo General Insurance

It is an excellent step in my view, encouraging and would support towards protecting not only policyholders' interests but also the public at large.

This regulatory initiative would increase the scope of the insurers’ cashless services which would play a pivotal role in reducing the financial burden on policyholders. This will also provide a strong network of health care plus insurance services countrywide.

Expert: Bhaskar Nerurkar Head – Health Administration Team, Bajaj Allianz General Insurance.

The regulatory move would broaden the scope of insurers' cashless services, which will be critical in lowering the financial burden on policyholders. This will also create a robust network and penetration of health care and insurance services across the nation.

Besides, the recognition of the AYUSH centers clause has also changed. Each insurer will have a board-approved policy for hospital empanelment, as per these revisions. The requirements might serve as a guide for creating an insurers' network partner empanelment policy.

Expert: Apaar Kasliwal – ED, PolicyBoss.com (Landmark Insurance Brokers Pvt. Ltd.)

With this announcement, the regulator has made a very strategic move to benefit the entire ecosystem, which should boost overall health insurance penetration and increase policyholder confidence. This will result in increasing cashless hospital networks, especially in Tier 3 and 4 cities, which have relatively lower available options.

Insurers will now be able to act on the prospect as well as policyholder preferences with respect to choice of hospitals courtesy of higher flexibility and ease to act. Policyholders, in turn, stand to benefit from a wider choice of preferred hospitals available for cashless treatment and hospitalisation across India.

Expert: Amjad Khan, Director, Head Employee Benefits Practice, Anand Rathi Insurance Brokers Pvt Ltd

This move by the regulator is further testimony to strengthening the ease of doing business in India. This will not only empower Insurers to choose the best hospital network which suits their business and client commitment but also expand their cashless network ensuring the financial burden on the policyholders gets reduced substantially.

This change will further ensure a robust, sustainable, and efficient healthcare ecosystem further making the claims experience for the policyholders seamless.