These norms on settlement of Covid-19 health insurance claims will ensure that there’s an outer limit to settle the claims to keep policyholders ease as the topmost priority.
By Navneet Dubey, New Delhi
PUBLISHED ON APR 30, 2021 01:43 AM IST
Health insurers have been directed by the insurance regulator to decide and clear requests for cashless treatment and discharge from hospitals within an hour of receipt of the request.
These norms on settlement of Covid-19 health insurance claims will ensure that there’s an outer limit to settle the claims to keep policyholders ease as the topmost priority.
Currently, the turnaround time (TAT) for insurers for granting both cashless pre-authorization and for final discharge of the insured patient after getting the receipt of the final bill along with all requirements from the hospital is two hours. The same has been further reduced by one hour by the Insurance Regulatory and Development Authority of India (Irdai).
This move was required at this stage as the number of covid-19 cases is increasing at an explosive rate, said Vinay Taluja, chief product officer, Bajaj Capital. The new rules on settling claims within one hour will provide much-needed relief to patients who are struggling to pay their health-related expenses.
“This move will surely put pressure on health insurers from an operational perspective,” Taluja added.
Further, the regulator said that notwithstanding the one-hour outer limit of timelines specified, insurers are advised to process such requests promptly so that both authorizations for cashless treatment and discharge of the patient can be hastened to the maximum extent.
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