IRDAI Instructs Insurers to Authorise COVID-19 Claims in Less Than 1 Hour

Previously, settlement of COVID-related insurance claims was getting delayed, due to which the discharge process of patients was also getting stalled. In the wake of the rising COVID-19 cases, the Insurance Regulatory and Development Authority of India (IDAI) directs insurers to approve COVID-19 insurance claims within 60 minutes.

With this move, the settlement of insurance claims concerning COVID-19 is anticipated to be faster than before. IRDAI has released norms to insurance companies concerning the settlement of insurance claims related to COVID-19. With this decision, IRDAI aims at preventing any delay in the discharge of patients and hospital beds remaining unoccupied. This move is of great help to policyholders amidst the sudden spike in COVID-19 cases.

This move might probably pressure health insurers from an operational perspective; nevertheless, it will be beneficial for policyholders. IRDAI has announced the following directions to all insurance companies:

1. Decision on consent for cashless treatment concerning COVID-19 claims has to be conveyed to the network provider (hospital) in less than 60 minutes from the time of receiving the authorisation request in addition to other requirements from the hospital.
2. Decisions regarding the final discharge of COVID-19 patients have to be conveyed to the network provider in less than 60 minutes from the time of receiving the final bill, in addition to the other requirements from the hospital.

In the future, insurers will have to promptly process the COVID-19 insurance claims to facilitate faster authorisation for cashless treatment and discharge of patients to the maximum extent.

For any clarifications/feedback on the topic, please contact the writer at bhavana.pn@cleartax.in