IRDAI asks Health Insurance Companies to settle claims within 2 hours as COVID-19 scare spreads..!


IRDAI asks Health Insurance Companies to settle claims within 2 hours as COVID-19 scare spreads..!

A move aimed at alleviating pressure on the country's healthcare infrastructure currently facing the heat of the coronavirus outbreak

Insurance regulator IRDAI has directed insurers to take decision on health insurance claims within two hours, a move aimed at alleviating pressure on the country's healthcare infrastructure currently facing the heat of the coronavirus outbreak.

In light of prevailing conditions owing to COVID-19 as also taking into consideration the need for alleviating the pressure on the healthcare infrastructure, all the insurers shall decide health insurance claims expeditiously, it said in a circular.


In order to ensure that all health insurance claims are responded to quickly, the Insurance Regulatory and Development Authority of India (IRDAI) has directed insurers to "comply" with certain timelines.

"Decision on authorisation for cashless treatment shall be communicated to the network provider (hospital) within two hours from the time of receipt of authorisation request and last necessary requirement from the hospital either to the insurer or to the TPA whichever is earlier," the circular said.

Further, decision on final discharge should be communicated to the network provider within two hours from the time of receipt of final bill and last necessary requirement from the hospital either to the insurer or to the Third Party Administrator (TPA), whichever is earlier.

Irdai has also asked all general and health insurers (except ECGC and AIC) to issue appropriate guidelines to their respective TPA.

Regulation 27 of the IRDAI (Health Insurance) Regulations, 2016, specifies norms on settlement/ rejection of claim by insurers.


Share:

No comments:

Post a Comment

Popular Posts

Blog Archive

Recent Posts

Featured Post

2024 Recap: Indian Real Estate Sector Maintained Growth Momentum

Shrinivas Rao, FRICS, CEO, Vestian 2024 Recap: Indian Real Estate Sector Maintained Growth Momentum   2024 can be called the year o...