IRDAI directs insurance companies to decide on Covid-19 claim in one hour

Insurance regulator IRDAI has directed insurance companies to decide on a cashless claim for treatment of Covid-19 within 60 minutes of receipt of the final bill. This will enable the waiting patiently to get a bed soon. The Insurance Regulatory and Development Authority of India (IRDAI) has directed all general insurance and health insurance companies to report authorization regarding claims within 60 minutes of the hospital fulfilling all the requirements for cashless treatment of Covid-19.

The regulator has issued this guideline given the order of the Delhi High Court. The Delhi High Court had asked the regulator to inform the insurance companies of cashless approval within a maximum time of 30 to 60 minutes so that there is no delay in discharging the patients.

In compliance with the second wave of Covid-19 and the High Court directive, IRDAI has directed the insurance companies to get the final bill from the hospital in the case of the Covid-19 claim and within one hour of fulfilling the requirements. The network provider will need to be informed of their decision regarding the claim.

The IRDAI circular also states that insurance companies should not wait for the deadline and process the requested request as soon as possible so that authorization and discharge of cashless treatment of patients are allowed as soon as possible.

Insurance companies have been asked to issue appropriate guidelines to the concerned third-party administrators to ensure timely compliance with the rules.