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Important rule changes regarding mediclaim are possible after hospital treatment. Under this, health insurance companies cannot deny a mediclaim claim if a patient is hospitalized for less than 24 hours. If this happens, the patient’s obligation to remain admitted for 24 hours will end. Let us tell you that currently the patient has to stay in the hospital for at least 24 hours for mediclaim. If not, insurance companies reject the patient’s claim.
Discussions are going on with IRDA
According to a Times of India report, the Insurance Regulatory and Development Authority of India (IRDA), which oversees the country’s insurance industry, is preparing for this important change. The report said that the Ministry of Consumer Affairs has initiated discussions with IRDAI and the Department of Financial Services in this regard. Justice Ameshwar Prasad Sahi, Chairman, National Consumer Disputes Redressal Commission (NCDRC) emphasized the need for this. Justice Sahi said – In this age of technology, treatment and surgery are completed within a few hours. The situation is that if a person is not admitted to the concerned hospital for at least 24 hours for the surgery then the claims will not be accepted. This comes up in medical claims and medical negligence cases.
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In many cases 24 hours before the medical claim
However, in some cases at different district levels, medical claims are completed before 24 hours. Justice Sahi cited an instance where the Ferozepur District Consumer Commission held an insurance company liable for wrongly denying a medical claim based on hospitalization for less than 24 hours. Recently, courts in Punjab and Kerala have also passed historic orders on medical insurance claims. Under this, the requirement of 24 hours admission has been removed. However, it is still not implemented at the country level.
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Justice Sahi has also expressed concern over the challenges of giving mediclaim to patients treated for less than 24 hours. At the same time, Consumer Affairs Secretary Rohit Kumar Singh has also said that we are proceeding with this keeping in mind the interests of consumers.