Health Insurers to decide Coronavirus treatment claims within 02 hrs of receipt

The Insurance Regulatory and Development Authority of India (IRDAI) has said that health insurers have to decide on authorization for cashless treatment to the network provider (hospital) within two hours from the time of receipt of authorization request and last necessary requirement from the hospital.

The move is meant to ensure that health insurance claims of all coronavirus patients are dealt with swiftly.

“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 insurers shall decide health insurance claims expeditiously,” Insurance Regulatory and Development Authority of India (IRDAI) said in a circular.

Health insurers also need to communicate their decision on final discharge to the hospital within two hours from the time of receipt of final bill and last necessary requirement, the insurance regulator said.

“Decision on authorization for cashless treatment shall be communicated to the network provider hospital within two hours from the time of receipt of authorization request and last necessary requirement from the hospital either to the insurer or to the TPA whichever is earlier,” the insurance regulator said.

The insurance regulator has asked health insurers to issue appropriate guidelines to their respective third party administrators soon.

Earlier this week, the Finance Ministry had extended the renewal dates of health and motor insurance policies falling during the nationwide lockdown till May 15 to ensure continuity.

This extension is for policies that are due for renewal between March 25 and May 3.

“With a view to mitigate hardship to policyholders whose health and motor (third party) insurance policies are due for renewal during Covid-19 lockdown, the government has issued notification allowing policyholders to make payments on or before 15.05.2020 towards renewal of their policies,” the finance ministry had said in a tweet.

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