Top 6 Health Insurance Claim Rule Updates You Need to Understand

Top 6 Health Insurance Claim Rule Updates You Need to Understand

Top 6 Health Insurance Claim Rule Updates You Need to Understand

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The insurers need to clear a health insurance within the time span of 3 hours of receiving it from the hospital while getting discharged. There are specific health  insurance claim norms that are managed by the regulators. 

June, 24,2024

  1. Smooth Contactless, Cashless Transactions

Now, one can make digital, online payments, e- payments, card payments, etc regardless of the hospital he/she is admitted to and exercise the reimbursement benefits from the insurance being claimed.

  1. The waiting time for for pre-existing medical conditions has been reduced from 4 to 3 years. The insurers can claim insurance up to 3 years from the receiving of it.  This may compromise on the access to insurance  and medical aids for the patients to some degree. 
  1. Ayush Treatments are Free of Any Restriction

It means, any ayurvedic, homoeopathic, yoga treatments can be conducted for longer time as far the conditions are fulfilled. 

  1. 3 Hour Cashless Clearance

 Insurers must approve a claim within three hours upon receiving it from the hospital at discharge. Irdai has set a 1-hour timeframe for clearing claims requests upon admissions. It will help people without delaying the discharge and admission. 

  1. If you’ve had a health insurance plan for five years without a break, including moving between plans, insurers can’t deny claims unless it’s fraudulent, regardless of any disclosure errors.
  1. Claims with Multiple Insurance Policies

 It means one can make a claim for single hospitalisation with multiple health insurance policies to settle the claim.

Now, that you know these major changes to the rules and regulations associated with claiming health insurance, it’s time to stay updated, educate others, and make informed decisions for our health and well-being. 

Joyville