Faster Mediclaim: Cashless Approval in 1 Hour, Claim Settlement in 3 - New Health Insurance Rules

For patients and their anxious families, the agonizingly long wait for medical insurance claim settlements or cashless approvals may soon be a thing of the past. Relief could be on the horizon, promising a more streamlined and expeditious process.

The IRDAI announcement that the central government is poised to mandate stringent timelines for health insurers. Under the proposed regulations, cashless authorization requests would need to be approved within a swift one-hour window, and final claim settlements would be expected within a mere three hours.

An official elaborated that this initiative aims to broaden health insurance penetration, ensuring that "insured patients are shielded from the financial burden of escalating medical expenses." This aligns with the Union government's broader vision, announced by the Insurance Regulatory and Development Authority of India (Irdai) in November 2022, to deliver accessible and universal health insurance coverage by the year 2047.

"The intention is to establish standards akin to those of the Bureau of Indian Standards (BIS) within the insurance sector. This would serve to streamline the operational processes of the health insurance industry." The BIS is India's national standards organization.

Streamlining cashless approvals to one hour and claim settlements to three hours marks a positive regulatory shift. 

This move has the potential to significantly reduce patient anxiety during medical emergencies and improve the efficiency of the health insurance system. By addressing a major pain point, it could foster greater confidence in insurance and encourage wider adoption, contributing to the goal of universal healthcare access.