Health Insurance Rule Change: In a survey of local circles, it was revealed that the process of health insurance claim is very time consuming and in the last 3 years, 43% of the policyholders have faced various difficulties in settling the health insurance claim.
People have become very aware about health insurance after the Corona period. At the same time, the insurance regulator IRDAI is also continuously taking steps to provide relief to the policyholders taking it. Now the master circular issued by IRDAI, taking a big decision, is important in the direction of strengthening the policyholders and curbing the arbitrariness of insurance companies. The insurance regulator has implemented a new rule of 1 and 3 hours, which is going to be very useful for people in cashless treatment. Let us understand in five points how it will work?
1- You won’t have to wait for treatment
The recent changes made by IRDA in the cashless payment rules in health insurance will benefit the common people or the policyholders in many ways and the biggest of these is that the treatment will start on time. Actually, in many cases it is seen that at the beginning of treatment in the hospital, the relatives of the patient need to arrange money immediately on the instructions of the hospital and they get worried, but now this problem will not arise. Under the new guidelines, by giving 1 hour in approval for cashless treatment by the insurance companies, the policyholder will be able to start getting treatment in the hospital as soon as possible.
2- Claim will be settled within three hours
Till now, despite getting treatment under cashless health insurance, people had to struggle for claim settlement. But now this problem will be solved. Actually, Insurance Regulator IRDAI has made another big change in the rules related to health insurance claims that now as soon as the insurance companies get the request for discharge of the patient from the hospital, it will be necessary for the insurance companies to give their approval within just 3 hours. This means that the claim will be settled or the bill will be settled within 3 hours of the request for discharge of the patient.
3- Approval has to be given quickly
If a health insurance policy holder has to be hospitalized, till now in this situation, the hospital generates a request for cashless treatment and sends it to the concerned insurance company. After this, approval is given by the insurance company and sometimes it takes a long time, but now IRDAI has changed the rules and made it clear that insurance companies have to decide on such a request within just one hour and give their approval or disapproval on this request.
4- The hassle of paperwork is over
According to the master circular of IRDAI, under the new rules, the policyholder will now get relief from all kinds of paperwork. Actually, IRDAI has instructed the insurance companies that from onboarding the customers to renewal of the policy and all other types of services, end-2-end technical solutions should be available. Apart from this, now the policyholder will not have to submit any kind of document for claim settlement, rather the insurance companies will collect them from the concerned hospital themselves.
5- The policyholder will have every detail of the policy.
Now the insurance companies will not be able to hide any important thing while selling the health insurance policy to the customer, they will have to share every detail with them. According to the circular of IRDAI, the insurance companies will have to give a customer information sheet to the customers. It will include all the information about the policy given to him in very simple language, like whether it is cashless, what is the insurance amount, details of coverage, deductions during claim, apart from insurance coverage, all other related information will be included.
43% policyholders faced problems in 3 years
It is worth noting that earlier a survey conducted by Local Circles revealed that in the last three years, 43% insurance policyholders have faced various difficulties in settling their health insurance claims. According to the survey report, the process of claiming health insurance is very time consuming, as many policyholders and their family members are seen running here and there trying to process their claim on the last day of hospitalization.
