In any case, the policyholder will not have to wait till discharge from the hospital. If there is a delay of more than three hours, then any additional charge taken by the hospital will have to be paid by the insurance company from its own funds.
Earlier, a lot of difficulties were faced for cashless payment in health insurance, but now it will be done within 3 hours of receiving the discharge request from the hospital. Because the Insurance Regulatory and Development Authority of India (IRDAI) has made a big change in the process of cashless payment. The organization has issued a circular giving this information. Along with this, some more changes have also been made for the convenience of the people, so that consumers can make the payment without any hassle.
What’s in the circular?
In the circular issued by IRDAI on 29 May 2024, it has been said that in any case, the health insurance company will have to make a cashless payment of the claim made by the policyholder within three hours of receiving the discharge request from the hospital. Also, in no case will the policyholder have to wait till discharge from the hospital. If there is a delay of more than three hours, then any additional charge taken by the hospital will be funded by the insurance company to the shareholder.
If someone dies during treatment…
IRDAI has clearly stated in its circular that if an insurance holder dies in the hospital during treatment, then in such a situation the company will have to immediately start the process of payment of the claim. Also, the body of the deceased will also have to be removed from the hospital as soon as possible.
100 percent cashless payment
According to the circular issued by IRDAI, the policyholder can make his payment in 100 percent cashless form. In emergency cases, the insurer will have to take an immediate decision on cashless payment within one hour of receiving the request.
Also, IRDAI has directed the insurance companies to complete this work by July 31, 2024 and for the convenience of the people, insurance companies should also set up a desk in the hospital if possible so that the process of cashless payment can be made easy.
Some other changes
IRDAI has also made some other changes. Under which the insurer company has been asked to make insurance policies for all sections of the society along with every age. Apart from this, if the policy holder chooses to cancel his policy at any time during the insurance period, then he will get a refund of the premium / proportional premium for the policy period.
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