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IRDAI mandates cashless health claims by August 1

According to IRDAI’s Master Circular on health insurance business, insurers must decide on cashless authorisation requests within one hour of receipt and grant final authorisation within three hours of receiving the discharge request from the hospital.

News Arena Network - New Delhi - UPDATED: June 11, 2024, 05:31 AM - 1 min read

The Insurance Regulatory and Development Authority of India (IRDAI) has mandated that insurance companies must implement cashless settlement systems for health insurance claims by August 1, 2024.

IRDAI mandates cashless health claims by August 1


The Insurance Regulatory and Development Authority of India (IRDAI) has mandated that insurance companies must implement cashless settlement systems for health insurance claims by August 1, 2024.

 

This move aims to simplify and expedite the hospital bill settlement process for policyholders.

 

To meet this deadline, IRDAI has directed insurers to deploy the necessary systems and procedures by July 31, 2024. Insurers are also required to set up dedicated Help Desks at hospitals to assist with cashless requests and provide pre-authorisation digitally to policyholders.

 

The regulator emphasized the goal of achieving 100 percent cashless claim settlements, reducing the need for reimbursement claims to a minimum and only in exceptional cases.

 

According to IRDAI’s Master Circular on health insurance business, insurers must decide on cashless authorisation requests within one hour of receipt and grant final authorisation within three hours of receiving the discharge request from the hospital.

 

This initiative is expected to enhance the efficiency of health insurance claims and ensure that policyholders are not delayed in being discharged from hospitals due to payment issues.

 

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