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