HC directive to IRDA over cashless facility

Giving a ray of hope to several policyholders, the Delhi high court has asked the insurance regulator Insurance Regulatory and Development Authority (IRDA) to make certain arrangement to provide cashless facilities to policyholders following the dispute between insurance companies and Delhi-based hospitals due to which people having medical insurance are facing difficulties.

After hearing a petition of Vishal Ahuja, whose 53-year-old mother, a cancer patient, was allegedly refused cashless treatment in Dharamshila Cancer Hospital and other medical centres, Justice S. Muralidhar, said, “IRDA should, as a regulator of the insurance industry, intervene and ensure that such changes do not affect existing policyholders.”
The court made this observation after the additional solicitor general (ASG) informed it that cashless treatment facilities would be provided to Ahuja’s mother, a cancer patient, forthwith.
The court had taken strong exception to the remarks of IRDA chairperson published in a newspaper in which he was quoted as saying that it is a matter between insurance companies and hospitals and there is no regulatory issue involved in it.
In his defence, the hospital authorities said because of the dispute between insurance companies and hospitals regarding reimbursement of medical bills, the companies have decided to discontinue cashless facility for individual policy-holders.
Ahuja then approached the Delhi high court contending that he had paid extra premium to Oriental Insurance Company to avail the cashless facility and IRDA should be directed to settle the dispute between the insurance companies and the hospitals.

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