IRDAI Directs Health Insurers for Prompt Action On Covid-19 Claims

Discharge decisions to be communicated to network provider within 1 hour from the time of receipt of the final bill

IRDAI Directs Health Insurers for Prompt Action On Covid-19 Claims
IRDAI Directs Health Insurers for Prompt Action on Covid-19 Claims
PTI - 30 April 2021

The Insurance Regulatory and Development Authority of India (IRDAI) has directed insurance companies to convey their decision on authorisation for cashless treatment for Covid-19 claims to the hospital within a period of 60 minutes from the time of the receipt of authorisation request, along with all necessary requirements from the hospital.

Further, the regulator also said in a circular that the decision on the final discharge of patients covered in Covid-19 claims shall be communicated to the network provider within a period of one hour from the time of receipt of the final bill, along with all necessary requirements, from the hospital.

The IRDAI has given the directions in line with the High Court's directions in the wake of the prevailing conditions of Covid-19 cases in the form of the second wave.

"Notwithstanding the above outer limits of timelines specified, the insurers are advised to process such requests promptly so that both authorisation for cashless treatment and discharge of the patient can be hastened to the maximum extent."

It further said that the insurers shall issue appropriate directions to their respective third-party administrators for ensuring compliance with the specified timelines.

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