Insurance firms will have to decide on Covid claims within 60 minutes

By Asianet Newsable English  |  First Published Apr 30, 2021, 2:03 PM IST

In a major relief for policyholders, the Insurance Regulatory and Development Authority of India has directed insurers to decide on cashless Covid-19 treatment claims within 60 minutes of the receipt of the final bill.


In a major relief for policyholders, the Insurance Regulatory and Development Authority of India has directed insurers to decide on cashless Covid-19 treatment claims within 60 minutes of the receipt of the final bill.

The IRDAI directive came a day after the Delhi High Court told insurance companies that they cannot take several hours for approving bills of Covid-19 patients as it delays their discharge from hospitals and those in need of beds have to wait longer.

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The court had warned insurance companies or third-party administrators (TPA) taking 6-7 hours to process insurance claims will face contempt of court action.

Here is what the IRDAI order says:

* Insurers should communicate cashless approvals to the concerned hospitals/establishments within a maximum time period of 30 to 60 minutes so that there shall not be any delay in discharge of patients and hospital beds do not remain unoccupied.

* Both cashless preauthorization and final discharge of the insured patient should be done within a fixed turnaround time of two hours.

* Decision on the final discharge of patients covered in Covid-19 claims shall be communicated to the network provider within one hour from the time of receipt of the final bill along with all necessary requirements from the hospital.

NOTE: Asianet News humbly requests everyone to wear masks, sanitize, maintain social distancing and get vaccinated as soon as eligible. Together we can and will break the chain #ANCares #IndiaFightsCorona

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