Wednesday 24 January, 2024


24th January 2024: General and health insurance companies provide coverage to millions of citizens through health insurance policies. In the event of hospitalization, policyholders need not pay for treatment out of pocket with a cashless facility where insurance companies commit to covering the treatment costs at the hospital, provided the claim is admissible. This cashless facility is currently available only at hospitals where the respective insurance company has an agreement or tie-ups. If the policyholder chooses a hospital without such an agreement, the cashless facility is not offered, and the customer has to go for a reimbursement claim, further delaying the claim process.

In order to ease the burden of policyholders who get treated in a hospital not in the network of the Insurance Company, the General Insurance Council, in consultation with all the General and Health Insurance Companies, is launching the “Cashless Everywhere” initiative.

Under Cashless Everywhere, the policyholder can get treated in any hospital they choose, and a cashless facility will be available even if such a hospital is not in the network of the Insurance Company. This Cashless Everywhere is subject to:

  1. For elective procedures, the customer should intimate the Insurance Company at least 48 hours prior to the admission.
  2. For emergency treatment, the customer should intimate the Insurance Company within 48 hours of admission.
  3. The claim should be admissible as per the terms of the policy and the cashless facility should be admissible as per the operating guidelines of the Insurance Company.

Speaking on the initiative, Mr. Tapan Singhel, MD and CEO of Bajaj Allianz General Insurance, and Chairman of the General Insurance Council, said:

“It has been the constant endeavour of the GI Council to simplify the lives of policyholders and bring positive changes that benefit them. With this in mind, we are announcing “Cashless Everywhere”, to make customers' lives easy. Today if you see only about 63% of customers opt for cashless claims while the others have to apply for reimbursement claims as they might be admitted to hospitals that are outside their Insurer/TPA network. We feel this puts a significant amount of stress on their finances and makes the process long and cumbersome. We wanted to make the whole journey of claims a frictionless process, which will not just improve the policyholder’s experience but will build greater trust in the system. This we feel will encourage more customers to opt for health insurance. We also see this as a step towards reducing and in the long run, eliminating fraud, which has been plaguing the industry in a big way and reducing trust in the system. Overall, it’s a win-win for all the stakeholders”.


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