Insurers directed to decide on cashless claims for COVID-19 patients within 60 minutes

New Delhi: Insurance regulator IRDAI has directed insurance companies to take a decision on cashless claims for treatment of COVID-19 patient within 60 minutes of receipt of the final bill. A quick decision will enable the waiting patient to get a bed soon.

Following orders from the Delhi High Court, IRDAI has issued directions to all general insurance and health insurance companies to authorize within 60 minutes.

Further, the regulator also said in a circular that the decision on the final discharge of patients covered in COVID-19 claims shall be communicated to the network provider within a period of one hour from the time of receipt of the final bill, along with all necessary requirements, from the hospital.

"Notwithstanding the above outer limits of timelines specified, the insurers are advised to process such requests promptly so that both authorisations for cashless treatment and discharge of the patient can be hastened to the maximum extent," the circular read.

The Delhi High Court had ordered that the IRDAI direct the insurance companies to settle the cashless claims quickly. IRDAI has asked all the insurance companies to inform all concerned that cashless claims should be settled within an hour after the COVID-19 patient is admitted to the hospital and submits all the necessary documents.

Meanwhile, news agency IANS cited a senior industry official preferring anonymity saying that it is going to be a tall order to meet.

Firstly, the officials of Third Party Administrators (TPA) are also working from homes managing handicaps like fast net connectivity, power cuts and many of them are also affected by COVID-19, the official said.

Notably, the number of coronavirus patients in the country is rising at an alarming rate. The strict restrictions imposed by the government are unable to reduce the speed of the virus spread. This has resulted in congestion in private and government hospitals across the country. People are not getting beds and oxygen. In such a case, delay in settling the insurance claim increases the problem further.