Insurers Must Tell Hospitals about Cleared Claims in 1 Hour

Insurance Regulator and Development Authority of India (Irdai) has told insurers to communicate their cashless approvals for COVID-19 claims within an hour of submission of the request by the hospital and ensure that patients get discharged soon, The Times of India reported. In its order, the Delhi HC had told Irdai to issue immediate instructions to insurance companies to ensure that they communicate their approvals to hospitals within 30 to 60 minutes, in order to ensure that patient discharge is not delayed. It further advised insurers to process such requests promptly so that both the authorization for cashless treatment and discharge of the patient is speeded up. Earlier, a turnaround time of two hours for granting both cashless pre-authorization and final discharge of the insured patient was specified by the regulator. The fast-tracking of COVID-19 health claims process comes in the wake of multiple reports of patients being denied cashless services by hospitals despite having proper insurance covers. While Irdai has issued guidelines directing policyholders to inform their insurance companies promptly about such anomalies, it has said that insurers can lodge complaints about errant hospitals with the respective state governments. Read more.

Location