Decide on cashless Covid treatment in an hour: Irdai to insurance firms

Order follows a Delhi HC directive to the insurance regulator on this issue

The Insurance Regulator and Development Authority (Irdai) on Thursday asked all general and health insurance companies to communicate their decision on the authorisation of cashless treatment for Covid-related claims to network providers within an hour of receiving the request.
 
Also, they have to communicate their decision on the final discharge of patients, whose Covid claims are covered, within an hour of receiving the final bill from the hospital.
 
This follows the Delhi High Court’s direction to the insurance regulator to advise insurers to communicate their cashless approvals to the hospitals/establishments within a maximum 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.

 

“Notwithstanding the above outer limits of timelines specified, the insurers are advised to process such requests promptly so that both authorisation for cashless treatment and discharge of the patient can be hastened to the maximum extent,” Irdai said in its circular.
 
Earlier, the regulator had requested network providers (hospitals) to provide cashless treatment to policyholders for all treatments covered by the policy, including Covid-19, as per the terms of service level agreements.
 
The regulator had also issued a communication to insurance companies that they should ensure all network provider hospitals extend the cashless facility for any treatment to the policyholder, including Covid-19 treatment, under agreed provisions.