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Delhi HC directs cashless service to all hospitals

In the High court of Delhi, W.P.(C) 6237/2019, DELHI OPHTHALMOLOGICAL SOCIETY vs UNION OF INDIA, application was filed by the association of ophthalmologists in Delhi High court who alleged General Insurance Public Sector Association (GIPSA) of acting like a CARTEL and failing to observe transparency in the empanelment process. Till now the GIPSA, group of public sector insurance companies formed in 2011 was only honouring cashless claims with empanelled hospitals.

By the original interim order,  Putting an end to a system where the companies and TPAs insisted that a hospital had to be registered with them, the court in its interim order ruled that insurance companies will give empanelment to all healthcare providers duly registered with respective state authorities for cashless facility. the order, an interim ruling, was passed on May 31. Though the said order was limited to patients seeking eye treatment, the court found fault with the very basis of GIPSA’s guidelines and the external system of “network hospitals” to exclude government-registered hospitals.

The court directed that till the next date of listing/hearing, the benefit to the persons who have taken the insurance policies shall be granted strictly in accordance with the terms and conditions of the insurance policies and no other direction, order or system being followed shall be implemented till the next date and further directed that the benefit of providing cashless service be also extended to such medical health providers whose names may not be registered online with GIPSA but if they are registered with the respective State authorities as per the local law of the State as applicable to a particular State, the cashless service be extended even to these medical health providers/beneficiaries.

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