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Health insurers are going to get a big benefit from August 1, 2024. Cashless settlement of health insurance claims will come into effect from this date. As soon as this practice is implemented, policy holders will get ease and speed in settling hospital bills. The Insurance Regulatory and Development Authority of India (IRDAI) said that insurance companies should immediately take necessary steps to implement this rule. There should be no delay in implementing the rule after July 31, 2024. The insurance regulator urged insurance companies to arrange physical help desks in hospitals for easy task management and cashless requests. Insurance companies should also arrange for pre-authorization of policyholders through digital mode. Every insurance company should try to settle 100 percent cashless claims within the time limit. The insurance regulator further said in the circular that insurers should decide on the request for cashless authorization immediately, but not later than one hour after receiving the request. Insurance companies will have to discharge the insured from all procedures within three hours of receiving discharge approval from the hospital. If there is a delay of more than three hours and any charges are levied by the hospital, it will be the responsibility of the insurance company.
What did the insurance regulator say?
Insurance companies will arrange for physical dedicated help desks in hospitals for cashless claim settlement
Within three hours of discharge from the hospital, insurance companies complete all the necessary procedures and allow the insured to go home
Under no circumstances should insurance companies wait for the policyholder to be discharged from hospital to settle the performance
The insurance regulator said insurers cannot reject claims without the approval of the Product Management Committee (PMC) or the three-member Claim Review Committee of the PMC.
