IRDA ask Health Insurers to settle claims within 2 hours as COVID-19 spreading like fire

New Delhi: Insurance regulator IRDAI has directed insurers to take a decision on health insurance claims within two hours, a move aimed at alleviating pressure on the country's healthcare infrastructure currently facing the heat of the coronavirus outbreak.


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 process health insurance claims expeditiously, it said in a circular.


In order to ensure that all health insurance claims are responded to quickly, the Insurance Regulatory and Development Authority of India (IRDAI) has directed insurers to "comply" with certain timelines.

"Decision on the authorization for cashless treatment shall be communicated to the network provider (hospital) within 2 hours from the time of receipt of authorization request and last necessary requirement from the hospital either to the insurer or to the TPAs (Third Party Administrators)whichever is earlier," the circular said.

Furthermore, the decision on final discharge should be communicated to the network provider within two hours from the time of receipt of the final bill and the last necessary requirement from the hospital either to the insurer or to the Third Party Administrator (TPA), whichever is earlier.