The Insurance Regulatory and Development Authority of India (IRDAI) advised insurers on Thursday to make decisions on cashless COVID-19 care claims within 60 minutes of receiving the final bill so that the hospital bed can be easily made available to another patient in need.
This action by the regulator comes as a huge relief to policyholders at a time when the number of Covid-19 cases is rapidly increasing. Certain COVID-related lawsuits took a long time to resolve, causing the patient's discharge to be delayed.
In its 28.4.2021 Order, the High Court of New Delhi ordered IRDAI to advise insurers to communicate their cashless approvals to the concerned hospitals and establishments within a maximum time span of 30 to 60 minutes so that patients are not delayed in being discharged and hospital beds are not left unoccupied.
According to the IRDAI's circular, insurers are advised to process such requests promptly, regardless of the time limits stated, so that both authorizations for cashless care and discharge of the patient can be expedited to the maximum extent possible.
The insurers have also been asked to give their respective Third Party Administrators (TPAs) the necessary instructions to ensure that the deadlines are met.
The government has set a ceiling on the cost of COVID-19 care in hospitals. However, not all hospitals adhere to these rates, and insurers prefer that the previously agreed-upon terms be followed.