Healthcare relief

THE Insurance Regulatory and Development Authority of India (IRDAI) has taken a much-needed step to smoothen the health insurance landscape by mandating a three-hour limit for settling cashless health claims. This significant directive is aimed at enhancing the efficiency and customer-centricity of health insurance services in India. By stipulating that insurers should decide on cashless authorisation within an hour and settle claims within three hours of discharge, the regulatory authority is setting a new benchmark for responsiveness and reliability in the sector.

Health insurance claims pose major challenges to customers. Lengthy processing often results in financial strain as patients and their families must raise funds immediately to pay hospital bills. Delays in cashless claims can lead to additional charges, prolonged hospital stays and potential disruptions in treatment. The rigmarole exacerbates the patients’ stress. Further, erratic service and a lack of transparency contribute to deep distrust in the system, deterring many from purchasing health insurance policies altogether. The new directive also includes a provision for a no-claim bonus and mandates a wider range of products to be offered by insurers, catering to the needs of all kinds of patients.

These reforms are aimed at boosting customer confidence and, subsequently, increasing insurance penetration in a country where health insurance coverage remains relatively low, with a significant section of the population reliant on government schemes. The lack of awareness about health insurance is another stumbling block. By streamlining the claims process and suggesting a discount on the premium amount for claim-free years, the IRDAI has taken on these challenges head-on. It must now ensure that the health insurance companies align their operations with the new guidelines by the July 31 deadline.