Convey decision to hospitals in an hour, IRDAI tells insurers

Time taken by insurers to give approval is one of the reasons for hospitals denying cashless treatment

Sixty minutes is within which health insurers must convey their decision on cashless treatment claim authorisation to hospitals. Similarly, they must inform their decision on the final bill also within one hour. Instructions in this regard were issued by Insurance Regulatory and Development Authority of India on Thursday. It followed an April 28 order of Delhi High Court, on a writ petition, directing IRDAI to advise insurers to communicate cashless approvals to hospitals/establishments within a maximum of 30-60 minutes. This was to ensure against delay in discharge of patients and hospital beds do not remain unoccupied, the IRDAI said referring to the court order. In a circular to the insurers, the regulator said “decision on authorisation 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 authorisation request along with all necessary requirements from the hospital.”