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After Delhi High Court order, IRDAI directs fast-tracking discharge of COVID-19 patients

The Insurers have been asked to issue appropriate directions to their respective Third Party Administrators (TPAs) for ensuring compliance with the timelines specified.

Aditi

Pursuant to Delhi High Court order, the Insurance Regulatory Authority of India has issued a slew of directions on the fast-tracking discharge of COVID-19 patients availing insurance policies.

The directions are:

- Decision on authorization for cashless treatment for COVID-19 claims shall be communicated to the network provider (hospital) within a period of 60 minutes from the time of receipt of authorization request along with all necessary requirements from the hospital.

- Decision on final discharge of patients covered in COVID-19 claims shall be communicated to the network provider within a period of ONE hour from the time of receipt of the final bill along with all necessary requirements from the hospital.

Notwithstanding the above outer limits, IRDAI has advised insurers to process requests promptly so that both authorisation for cashless treatment and discharge of the patient can be hastened to the maximum extent.

The Insurers have been asked to issue appropriate directions to their respective Third Party Administrators (TPAs) for ensuring compliance with the timelines specified above.

On April 28, the Division Bench of Justices Vipin Sanghi and Rekha Palli had direct all insurance companies and TPAs to ensure that time taken to grant NOCs should be reduced.

On the same day, Bench of Justice Prathiba M Singh also directed IRDAI to issue a direction to all insurance companies that the maximum time within which insurance claims of patients was to be approved was within 30 to 60 mins.

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