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IRDAI Directs Health Insurers to Decide COVID-19 Claims within Two Hours

Updated On Jun 23, 2020

In a significant move to alleviate pressure on the healthcare infrastructure in the country and ensure all the coronavirus health insurance claims are responded quickly, the Insurance Regulatory and Development Authority of India (IRDAI) has asked all health insurance companies in the country to decide and clear health insurance claims requests related to coronavirus disease within two hours.

The insurers have to clear the claims within two hours from the time of receipt of authorization request and last necessary requirement from the hospital. With this, health insurance companies will make decisions on authorization for cashless treatment to the network hospitals, respond and settle claims quickly given the current coronavirus pandemic.

The IRDAI has said in a circular “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," 

The insurance regulator has directed health insurance companies to issue appropriate guidelines to their respective third-party administrators (TPA).

In another step, the Government has also issued a notification that allows policyholders to make payments on or before 5th May 2020 towards the renewal of their policies. This step has been taken to mitigate hardship to policyholders whose health and motor (third party) insurance policies are due for renewal during coronavirus lockdown.

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