IRDAI introduces new rules for faster, hassle-free health insurance claims. All entitlements are now in a single master circular.
Insurers must grant final authorization within 3 hours of receiving the discharge request from hospitals to ensure a seamless claim process.
For emergency cases, insurers must decide on cashless authorizations within one hour to expedite claim settlements.
Insurers should aim for 100% cashless claim settlement, with help desks in hospitals to assist with requests.
Policyholders can choose products, add-ons, and riders that cater to diverse needs, including different medical conditions and treatments.
Policyholders can choose to increase their sum insured or receive a premium discount as a No Claim Bonus if no claims are made during the policy period.
In the event of a policyholder's death during treatment, insurers must process claims immediately and release the body from the hospital.