look news india
health insurance: The Insurance Regulatory and Development Authority (IRDAI) has taken a big decision in the interest of health insurance policyholders.
IRDAI on Wednesday issued a circular on health insurance, clarifying that the insurance company has to take a decision on approving cashless treatment within one hour of the policyholder seeking a claim.
Insurance companies have to settle the claim within three hours of receiving the discharge. If the claim is not settled within three hours, the insurance company will reimburse the hospital charges levied on it.
What did IRDAI say?
IRDAI has issued a master circular and cancelled 55 circulars on health insurance. According to this circular, the policyholder will get the facility of claim settlement within 3 hours of request. IRDAI has said that the insurance company will have to settle the claim within three hours of discharge from the hospital.
Do not wait until you are discharged from hospital
The insurance regulator has said that under no circumstances should the patient wait to be discharged from the hospital. If there is a delay of more than three hours in discharging the policyholder patient from the hospital, the additional amount (if any) charged by the hospital will be paid from the shareholders' fund of the insurance company.
If the policyholder dies during treatment..
If the policyholder dies during treatment, the insurance company has to immediately start the claim settlement process. Apart from this, the body of the deceased also has to be taken out of the hospital quickly.
When will these rules come into effect?
IRDAI has asked insurance companies to implement these rules by July 31. Hospitals can also arrange help desks for cashless claims.
