Winning Bizness Desk

Mumbai. There has been a big relief to crores of health insurers across the country as their health insurance cashless settlement will be done within three hours. It looks a little unbelievable, but this is going to be reality in a few days. Suppose you have been in the hospital for a few days and a doctor comes on rounds and declares you fit for discharge. Now you pack your bag to go home, then the hospital staff asks you to wait for some more time. Afternoon turns to evening, but you are not discharged from the hospital, because your health insurance claim has not been cleared yet. The staff says that the hospital will not discharge you until the insurer signs the bills. The staff says that if it takes a few more hours, you will have to spend another night in the hospital. This will also increase your hospital bill. This happens with lakhs of people every day. People have to endlessly wait despite being declared fit for discharge.

IRDAI issued a master circular

In view of this problem, the Insurance Regulatory and Development Authority of India (IRDAI) has issued a master circular and has repealed 55 circulars and brought all the rights of the policy holder in health insurance at one place. IRDAI said that the insurance company will have to give final authorization within 3 hours of receiving the discharge request from the hospital. Under no circumstances can the policy holder be made to wait for discharge from the hospital. If there is a delay of more than 3 hours in discharging the policyholder and the hospital charges extra, then the insurance company will bear that charge. Its burden cannot be put on the policy holder.

Time limit for free look cancellation is 30 days

The moratorium period has been reduced from 8 years to 5 years. If no fraud is proved after 60 months of continuous coverage, then the health policy and claim will not be disputed. The waiting period for previous diseases will be 3 years. Free look cancellation period now extended to 30 days. The regulator said that in case of death of the policyholder during treatment, the insurer should promptly act on the request for claim settlement and immediately release the body from the hospital.