Guide · last reviewed 10 October 2026
IRDAI's one-hour cashless rule, and when the clock starts
Under IRDAI's Master Circular of 29 May 2024, an insurer must decide a cashless authorisation request immediately and not more than one hour after receiving it, and must give final authorisation at discharge within three hours of the hospital's request. The clock starts when the insurer receives the request, not when the doctor advises admission, so the hospital's own preparation time is not counted.
What the rule says
The rule is in IRDAI's Master Circular on Health Insurance Business, issued on 29 May 2024 under the IRDAI (Insurance Products) Regulations, 2024. Reproductions of the circular print its reference as IRDAI/HLT/CIR/PRO/84/5/2024. It sets two time limits on the insurer for cashless claims.
| Stage | Time limit on the insurer | Counted from |
|---|---|---|
| Cashless authorisation (pre-authorisation, at admission) | Immediately, and not more than one hour | Receipt of the request |
| Final authorisation (at discharge) | Within three hours | Receipt of the discharge authorisation request from the hospital |
“immediately but not more than one hour”
IRDAI Master Circular, 29 May 2024, on deciding a cashless authorisation request
“final authorization within three hours of the receipt of discharge authorization request”
IRDAI Master Circular, 29 May 2024, on discharge
If the insurer takes longer than three hours at discharge, the circular says the additional amount charged by the hospital, if any, is to be borne by the insurer from its shareholders' fund. The patient is not meant to pay for the insurer's delay.
When the one-hour clock starts
The hour is counted from the insurer's receipt of the request. It does not start when the doctor advises admission, when the family reaches the insurance desk, or when the hospital begins filling the form.
That is why a hospital can be dealing with an insurer that meets the rule and still have patients who wait most of a day. Everything before the request is sent happens on the hospital's side: the walk to the desk, the search for documents, the doctor's form, the typing into the payer's portal. Nobody times those hours.
The passages of the circular quoted in this guide do not say what happens to the hour when the insurer or TPA comes back with a query. How each payer treats that time is worth asking your TPAs directly, and it is a reason to send a complete request the first time.
What else the circular requires on cashless claims
- Every insurer is to strive for 100% cashless claim settlement in a time-bound manner.
- Insurers were to put the necessary systems and procedures in place immediately, and not later than 31 July 2024.
- Insurers may arrange dedicated help desks, in physical mode, at the hospital to deal with cashless requests.
- Insurers are to provide pre-authorisation to the policyholder through digital mode as well.
- If the patient dies during treatment, the insurer is to process the claim immediately and have the mortal remains released from the hospital immediately.
- Insurers, with the insurance councils, may endeavour to onboard hospitals on the National Health Claims Exchange (NHCX). See what NHCX is.
The circular came into force with immediate effect, except where a specific date is given. Existing products that did not comply were to be modified by 30 September 2024.
Why patients still wait
Two published figures look like they contradict each other, and both can be true.
| Figure | What it measures | Source |
|---|---|---|
| 96.7% | Insurers' reported compliance with the timelines | Stated in Parliament, December 2025 |
| 6 in 10 | Patients who said they waited 6 to 48 hours | LocalCircles survey, January 2025 |
The first measures the insurer from the moment a request arrives. The second is the family's whole experience, most of which happens before a complete request exists.
What a hospital can do about its side of the clock
- Time it. Record when the doctor advises admission and when a complete request reaches the insurer. Most desks have never measured this gap.
- Start earlier. Collect the policy, identity documents and consent in the consulting room or on the patient's phone, not at the counter.
- Send a complete request the first time. Check each payer's required documents and fields before filing.
- Stop re-typing. Capture each fact once, from the person who knows it: patient, doctor, desk.
- Tell the family where things stand. A reference number and a visible status remove most trips to the counter.
How Claims Ignite handles this
Claims Ignite is built for the part the rule does not time. The patient scans the doctor's QR and gets a reference number at once, photographs the policy, Aadhaar and PAN, and the doctor and insurance desk complete one shared record. The payer's own validators run before filing, so the request is complete when it is sent.
It then shows two clocks: the hospital's own time to a complete request, and the insurer's hour once the request is received. The patient sees the insurer's clock on their phone.
Quick questions
How long does an insurer have to approve a cashless pre-authorisation in India?
Under IRDAI's Master Circular on Health Insurance Business dated 29 May 2024, the insurer must decide a cashless authorisation request immediately and not more than one hour after receiving it.
How long does an insurer have to approve discharge?
The insurer must grant final authorisation within three hours of receiving the discharge authorisation request from the hospital. If it takes longer, any additional amount charged by the hospital is borne by the insurer from its shareholders' fund.
When does the IRDAI one-hour clock start?
When the insurer receives the cashless authorisation request. It does not start when the doctor advises admission or when the patient reaches the insurance desk, so time spent preparing the request on the hospital's side is not counted.
From when has the one-hour rule applied?
The circular was issued on 29 May 2024 and took effect immediately. Insurers were required to have the necessary systems and procedures in place no later than 31 July 2024.
Does the rule apply to the hospital?
The time limits are placed on the insurer. The hospital's own steps before the request is sent are not timed by the rule, which is where most of a patient's wait usually sits.
Sources
- IRDAI, Master Circular on Health Insurance Business, 29 May 2024 · the primary document
- TaxGuru, text of the Master Circular on IRDAI (Insurance Products) Regulations 2024, Health Insurance · reproduction used for the quoted wording
- LocalCircles survey, January 2025, and compliance figure stated in Parliament, December 2025 · as reported; not re-verified by us
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