One of the most beneficial and attractive features of health insurance coverage is cashless mediclaim. This feature, till recent times, was applicable only to hospitals under the insurer’s network. With recent developments, patients with existing insurance policies can get coverage for hospital expenses even if the hospital they are admitted to ceases to be a part of the preferred provider network (PPN) of their insurer.

This news follows the heels of the Mumbai-based Insurance Regulatory and Development Authority’s (IRDA) recent order wherein all life and general insurance companies will allow cashless facility to patients who are already being treated. Policy-holders who suffered when ublic sector general insurance companies removed as many as 300 hospitals from their PPN list - and now they can heave a sigh of relief with this directive in place.

According to industry experts, the over-pricing issues at the heart of this ongoing battle between PPN and insurers are on the verge of attaining successful closure. As a rule of thumb, insurance providers discourage policy-holders from availing cashless treatment at non-network hospitals. This list of PPN is easily accessible when a potential buyer acquires health insurance quote and can at times, be a decisive factor in the purchase, depending on the needs of the customer.

IRDA also requires the insurance companies to intimate existing policyholders about changes in their PPN lists. The order states, “The insurers are directed to inform policyholders the nearest alternative hospitals where the cashless facility is available.” In line with IRDA’s order, several public sector general insurers have begun making arrangements to ensure improved services to policyholders.

Private sector companies offering health insurance coverage are individually reaching out to policy-holders. According to the CEO and managing director of a well-known insurance provider, the PPN list seldom undergoes any changes and if a change does take place, insurers are prompt to inform each policyholder.

The customer care centres of insurance companies can also be accessed to gain additional information regarding hospitals that offer cashless mediclaim facility. As far as life insurance companies are concerned, the health insurance portfolio is quite small, ranging from one to five per cent. Most of them have tie-ups with third-party administrators and claim that they keep each policyholder informed about the smallest of changes in their policies and hospital tie-ups via newsletters and electronic mails.