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Insurance

Hospital avoiding cashless treatment

Even with implementation of new rules for cashless treatment at every hospital regardless of hospital network tie-up, the hospital is denying cashless treatment for insurance holder saying that the previous amount claim of patient is not yet processed for the past one month. Kindly advice on how to handle this?

( Palakkad, Kerala )

1 year ago

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A.
Dear Client,
In the given situation, bring the matter to the notice of the Grievance Cell of the concerned Insurance Company endorsing a copy to the insurance regulatory authority, IRDIA. In case, no suitable reply is received or received a reply denying your claim, then file a complaint before the Dist. Consumer Commission against the concerned hospital and the Insurance Company on the grounds of deficiency and unfair trade practices claiming the entire medical treatment cost incurred for the treatment of the insured patient along with compensation of harassment. Claim should be filed within two years from the date of cause of action, i.e, the date of rejection of the claim. Reach out to an Advocate for guidance and steps.
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