IRDAI new rule: Now there is no need to be admitted for 24 hours for mediclaim, know which treatments will be exempted

IRDAI new rule: Now medical claims can be taken even without being admitted to the hospital for 24 hours. According to the new rules of the Insurance Regulatory and Development Authority (IRDA), it is not necessary to be hospitalized for 24 hours to get a claim for medical insurance.

Nov 7, 2023 - 12:51
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IRDAI new rule: Now there is no need to be admitted for 24 hours for mediclaim, know which treatments will be exempted
IRDAI new rule: Now there is no need to be admitted for 24 hours for mediclaim, know which treatments will be exempted

Insurance holders will benefit from the new rules of the Insurance Regulatory and Development Authority (IRDA). Now there will be no need for 24-hour hospitalization for medical claims. According to the new rules of IRDA, medical claims can now be taken even without being admitted to the hospital for 24 hours. Insurance companies will have to make separate provisions for this. This claim can be taken under day-care treatment. This rule will provide a lot of convenience to the insured.

Insurance regulator IRDAI, while clarifying the definition of hospitalization, has added a new term called day-care in the rules. Under this, such treatments will be included, in which any surgery is completed within 24 hours or involves conditions like the use of anesthesia. In such cases, 24-hour hospitalization will not be necessary. Recently, the consumer court of Gujarat had given a verdict against the insurance company in the case of not being admitted to the hospital for 24 hours. Now IRDA has made rules on this.

The treatments for which claim can be taken without spending 24 hours in the hospital include tonsil operation, chemotherapy, cataract operation, sinus operation, radiotherapy, hemodialysis, coronary angiography, skin transplantation, and knee operation. This type of treatment does not require 24-hour hospitalization.

Under day-care treatment, insurance companies will give claims to those who do not spend 24 hours in the hospital, but the insured will also have to bear some loss. Under the rule, doctor's consultation fees, tests, investigation expenses, etc. will not be included. Outpatient care has also been included in this category.

Muskan Kumawat Journalist & Writer