New IRDAI Health Insurance Rules: Anushka Rathod Shares the Details

Are you aware of the new health insurance rules that can save you money? The Insurance Regulatory and Development Authority of India (IRDAI) has released a master circular on health insurance, which all insurance companies must follow immediately, except where a specific date is mentioned. Anushka Rathod, a finance content creator, shares these important updates.

Cashless Facility

Insurance companies must decide on cashless authorization within one hour of receiving a request. This system must be in place by July 31, 2024. This rule ensures quicker processing and less hassle during medical emergencies.

Final Authorization for Discharge

Insurers are required to give final authorization within three hours of receiving a request from the hospital. If there is any delay beyond this timeframe, the insurer will cover the extra charges, ensuring smoother discharge processes.

Claim Rejection

After five continuous years of holding a health insurance policy, the insurer cannot dispute claims based on undisclosed information unless fraud is proven. If a claim is denied or partially disallowed, the insurer must provide detailed reasons and specific references to the policy terms and conditions.

New Technology and Procedures

Insurers are encouraged to include new technological advancements and treatments in their products, such as stem cell therapy and oral chemotherapy. This inclusion ensures that policyholders have access to the latest medical treatments.

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The new IRDAI health insurance rules aim to improve service efficiency, ensure transparency, and provide access to advanced medical treatments. By understanding these changes, you can make more informed decisions about your health insurance and potentially save money. Keep these updates in mind to fully benefit from your health insurance policy.