Health Insurers Have To Decide Coronavirus Treatment Claims Within 2 Hours

Also, health insurers have 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.

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

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.”

Also, “decision on final discharge shall be communicated to the network provider within two hours from the time of receipt of final bill and last necessary requirement from the hospital either to the insurer or to the TPA whichever is earlier.”

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

Earlier this week, the Finance Ministry extended the renewal dates of health and motor insurance policies falling during the nationwide lockdown period 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 & motor (third party) insurance policies are due for renewal during COVID-19 lockdown, Govt. has issued notification allowing policyholders to make payments on or before 15.05.2020 towards renewal of their policies,” the finance ministry said in a tweet.-Livemint