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IRDAI Working to Make 100% Cashless Medical Claims a Reality Soon

Written by : Dr. Aishwarya Sarthe

September 11, 2023

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During the three-day global fintech festival, Debasish Panda, chairman of the Insurance Regulatory and Development Authority of India (IRDAI), announced the regulator's collaborative efforts with health insurers, the National Health Authority and the Insurance Council to expedite the implementation of 100% cashless claim settlements.

The Insurance Regulatory and Development Authority of India (IRDAI) has announced its concerted efforts to ensure 100% cashless settlement of medical expense claims in collaboration with health insurance providers. 

Speaking at the Global Fintech Festival, IRDAI chairman Debasish Panda stated that the regulator is actively engaging with health insurers, the National Health Authority (NHA) and the Insurance Council to expedite the implementation of 100% cashless claim settlements. 

The information comes in response to the existing hurdles in the cashless claim process, where insurers often deduct 10% or more from the total billing under various pretexts.

However, Panda did not specify a timeframe for achieving this goal.

IRDAI is also actively collaborating with the Insurance Council and the National Health Authority to onboard more hospitals onto the National Health Exchange, a crucial step in streamlining the cashless claims process.

Despite insurance policies offering cashless admission benefits, many hospitals remain reluctant to embrace this feature. Hospital authorities frequently provide various reasons for this reluctance, adding complexity to the claims process.

Panda further revealed that the regulator is working closely with insurers to address the issue of affordable pricing for health insurance targeted at the elderly. 

The high pricing of mediclaim policies has made them unaffordable for a significant portion of the elderly population, making it an area of critical concern.

When discussing the ambitious goal of 'insurance for everyone' by 2047, when India celebrates its 100th birthday, Panda said, "We should work towards achieving this much earlier." 

Consequently, IRDAI has demonstrated its commitment to making insurance coverage accessible and transparent, ensuring every Indian citizen can access it.


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