IRDAI mandates health insurers to respond to cashless requests within one hour and authorize discharge within three hours. Delays beyond this duration will incur additional hospital charges borne by insurers. In case of policyholder demise during treatment, insurers must promptly settle claims and facilitate release of mortal remains. The master circular replaces 55 others, emphasizing insurers to prioritize cashless settlements and minimize reimbursement cases. Claims can’t be repudiated without Claims Review Committee approval. Policyholders with multiple health policies can choose the insurer for claim settlement, with primary insurers coordinating balance settlement from others.
Streamlining Health Insurance Processes: New Directives from IRDAI
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