Despite policyholders being entitled for getting cashless treatment under their medical insurance policy, there are some reports that some hospitals are not granting cashless facilities for COVID-19 treatment.
The policyholders may send a complaint to the concerned insurance company in the event of denial of the cashless facility at any such enlisted network providers hospitals.
Insurance Ombudsman or the Grievance Redressal Officer can also be approached. Policyholders' complaints/grievances are looked into by the Grievance Redressal Cell in the Consumer Affairs Department of the Insurance Regulatory and Development Authority of India (Irdai). This Cell takes up the grievances with the respective insurers for redressal.
Here is how to file a complaint
First approach the Complaints/Grievance Redressal Cell of the insurer concerned if policyholders have complaints against insurers. Policyholders may approach the Grievance Redressal Cell in the Consumer Affairs Department of the Irdai if they do not receive a response from the insurer within a reasonable period which is usually 15 day of the complaint receipt or are dissatisfied with the response of the company.
Frequently Asked Questions
A vaccine works by mimicking a natural infection. A vaccine not only induces immune response to protect people from any future COVID-19 infection, but also helps quickly build herd immunity to put an end to the pandemic. Herd immunity occurs when a sufficient percentage of a population becomes immune to a disease, making the spread of disease from person to person unlikely. The good news is that SARS-CoV-2 virus has been fairly stable, which increases the viability of a vaccine.
There are broadly four types of vaccine — one, a vaccine based on the whole virus (this could be either inactivated, or an attenuated [weakened] virus vaccine); two, a non-replicating viral vector vaccine that uses a benign virus as vector that carries the antigen of SARS-CoV; three, nucleic-acid vaccines that have genetic material like DNA and RNA of antigens like spike protein given to a person, helping human cells decode genetic material and produce the vaccine; and four, protein subunit vaccine wherein the recombinant proteins of SARS-COV-2 along with an adjuvant (booster) is given as a vaccine.
Vaccine development is a long, complex process. Unlike drugs that are given to people with a diseased, vaccines are given to healthy people and also vulnerable sections such as children, pregnant women and the elderly. So rigorous tests are compulsory. History says that the fastest time it took to develop a vaccine is five years, but it usually takes double or sometimes triple that time.
Complaints from the insured or the claimants are entertained. Complaints written on behalf of policyholders by advocates or agents or by any third parties are not entertained by the Cell.
Complete details of the complaint as required in the complaint registration form, which can be downloaded from the IRDAI website – policyholder.gov.in (http://www.policyholder.gov.in/Report.aspx#) have to be submitted by the complainants.
Here's how to register complaints with the Irdai
-Policyholders can make use of the Integrated Grievance Management System(IGMS). It is an Irdai Portal at https://igms.irda.gov.in for registering the complaints and monitoring the status of the complaints.
-You can send the complaint through Email to email@example.com.
-You can call Toll Free No. 155255 or 1800 4254 732-If you want necessary to send the communication in physical form, the same can be sent to Irdai official addressed to: General Manager, Insurance Regulatory and Development Authority of India(IRDAI), Consumer Affairs Department – Grievance Redressal Cell, Sy.No.115/1, Financial District, Nanakramguda, Gachibowli, Hyderabad – 500 032.