IRDA sets time limit to approve cashless claims in COVID-19 cases

Insurance Regulatory and Development Authority of India (IRDA) asked all insurance companies to convey a decision on approving all cashless claims against COVID19 hospitalisation within an hour.

The move should check delay in discharging patients, which in turn would make hospital beds available to new patients at a time when a second wave of coronavirus has crippled healthcare system across the country.

“Decision on authorization for cashless treatment for COVID-19 claims shall be communicated to the network provider (hospital) within a period of 60 minutes from the time of receipt of authorization request along with all necessary requirements from the hospital,” IRDA said in a notification on Thursday.

On Wednesday New Delhi High Court directed that the insurance regulator should advise insurers to communicate their cashless approvals to the concerned hospitals with a maximum time period of 30-60 minutes.

“Decision on final discharge of patients covered in COVID-19 claims shall be communicated to the network provider within a period of one hour from the time of receipt of final bill along with all necessary requirements from the hospital,” IRDA said.

The regulator insisted on prompt processing of claims so that both authorisation for cashless treatment and discharge of the patient can be hastened to the maximum extent.


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