look news india
New Delhi: IRDAI on Wednesday issued a new circular on health insurance, making it clear that insurers must take a decision on approving cashless treatment within one hour of the request. The new master circular on health insurance products replaces Circular Fifty-five issued earlier and is an important step towards empowering policyholders and strengthening inclusive health insurance, IRDA said in a statement.
The insurance regulator said that the circular has brought the eligibility in health insurance policies available to the policyholder at one place for easy reference. Along with this, the emphasis has been given to provide a hassle-free, quick claim experience to the policyholder for buying health insurance and to ensure advanced standards in the field of health insurance.
It said cashless authorisation requests will be decided immediately within one hour and final settlement will be done within three hours of discharge from the hospital after the request is made by the hospital.
Cashless payments in health insurance used to face many hurdles, but now the insurer will have to complete the cashless payment process within three hours of receiving the discharge request from the hospital. A circular issued by insurance regulator IRDAI on May 29, 2024 states that the health insurance company will have to pay the cashless claim made by the insured within three hours of receiving the discharge request.
Thus, under no circumstances will the policyholder have to wait for discharge from the hospital. Now if there is a delay of more than three hours and in such a situation any charge is taken by the hospital, then any additional charge will be borne by the insurance company.
