The Insurance Regulatory and Development Authority of India (IRDAI) has issued a new circular that promises to bring significant benefits to millions of people across the country. Here are the key points explained in a simple and presentable way:
1. Approval for Cashless Facility
Insurance companies are now required to ensure 100% cashless treatment for policyholders. This means:
- Guaranteed Cashless Treatment: Claim settlements must be cashless, with reimbursement being an option only in exceptional circumstances.
- Quick Response Time: The claim request must be processed within one hour of receipt.
2. Final Authorization for Discharge from the Hospital
New rules ensure a smoother discharge process from hospitals:
- Quick Discharge Approval: Insurance companies must grant final authorization within three hours.
- No Waiting: Patients and their families will not be made to wait. If there’s any delay, the insurer will bear the cost, not the policyholder.
- In Case of Death: If the policyholder dies during treatment, the insurer must immediately process the claim and ensure the prompt release of the body from the hospital.
3. Grace Period for Premium Payment
There is now a grace period for paying your premiums:
- Monthly Instalments: 15 days grace period.
- Quarterly/Half-Yearly/Yearly Payments: 30-day grace period. If you renew your policy within this timeframe, you will remain protected.
4. Lock-In Period
If you’re not satisfied with your policy, there’s a provision to cancel it:
- 30-Day Cancellation Option: You can cancel the policy within 30 days from the date of issuance if you are not satisfied with the product or terms and conditions. This is particularly helpful for cases of mis-selling.
5. Help Desks at Hospitals
To ensure convenience for patients, insurance companies are advised to set up help desks at hospitals.
This new circular from IRDAI is set to revolutionize the health insurance sector in India, making it more responsive and customer-friendly. With faster claim processing, extended grace periods, and better support at hospitals, policyholders can look forward to a smoother and more secure experience.
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