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Insurance Regulatory and Development Authority of India Circular Ref. No:IRDAI/HLT/MISC/CIR/113/04/2021 Date:29-04-2021 To All General and Health Insurers (Except ECGC AIC) Dear Madam /Sir, Re:Norms on settlement of COVID-19 health insurance claims 1. Reference is invited to
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FAQ :
Insurers must communicate their decision on cashless treatment authorisation for COVID-19 claims to the network hospital within 60 minutes of receiving the request and all necessary documents.
Insurers must communicate their decision on the final discharge of patients for COVID-19 claims to the network hospital within one hour of receiving the final bill and all necessary documents.
These new timelines have been introduced in response to the prevailing COVID-19 situation and a directive from the High Court of New Delhi to prevent delays in patient discharge and optimise hospital bed usage.
No, these specific timelines are for COVID-19 health insurance claims.
Yes, insurers are advised to process these requests promptly, even beyond the specified outer limits, to hasten both authorisation for cashless treatment and patient discharge.
All general and health insurers (except ECGC & AIC) and their respective Third Party Administrators must comply with these directions.
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Notification No : IRDAI/HLT/MISC/CIR/113/04/2021Published in Miscellaneous
Source : https://www.irda.gov.in/ADMINCMS/cms/whatsNew_Layout.aspx?page=PageNo4465&flag=1