Cashless Health Insurance Claim Authorisation in 2025: How Long Does It Take? IRDAI’s New Rules and Data

In 2025, the Insurance Regulatory and Development Authority of India (IRDAI) has strengthened rules for cashless health insurance claim approvals.  

Insurers are now required to process claims far more swiftly, ensuring minimal delays in both hospitalisation and patient discharge. 

IRDAI's Time-Bound Cashless Claim Approval Rules for 2025 

Effective from July 31, 2024, insurers are bound to strict timelines under IRDAI’s 'Master Circular on Health Insurance Business 2024'. For pre-authorisation requests made at admission, insurers must respond within 1 hour of receiving the claim request.  

For discharge, the final authorisation must be issued within 3 hours of the hospital’s authorisation request. 

If insurers fail to meet the 3-hour discharge timeline, any additional costs due to the delay must be covered by the insurer. In cases of the policyholder's death, the insurer must also assist in the immediate release of mortal remains and settle the claim without delay. 

Latest Claim Processing Data Shows High Compliance in 2025 

According to data shared by Finance Minister Nirmala Sitharaman in the Lok Sabha on December 1, 2025, the system has seen high compliance. Between August 1, 2024 and May 31, 2025: 

• 86.88% of pre-authorisation requests were processed within 1 hour (55,35,353 out of 63,71,620 cases)
• 96.69% of final authorisation cases were completed within 3 hours (54,92,758 out of 56,80,998 cases) 

Delays beyond the 3-hour limit were minimal: only 0.77% of cases took longer than 8 hours to process. 

Read More: Don’t Wait in Hospital: Cashless Insurance Claims in 2025 Have Now Become Faster!! 

Complaint Redressal Through Bima Bharosa 

The Bima Bharosa portal has been integrated with insurers' Complaint Management Systems (CMS), ensuring timely tracking and resolution. Insurers are mandated to resolve complaints within 14 days. In FY 2024-25, 2,57,790 complaints were received, and only 4,811 exceeded the resolution time. 

In FY 2025-26 (up to September 30, 2025), 1,36,554 complaints were received, with only 532 exceeding the time limit. Complaints not resolved on Bima Bharosa can still be escalated to the Insurance Ombudsman either online or offline. 

Conclusion 

With nearly 87% of cashless health pre-authorisations processed within 1 hour and 97% of discharges cleared within 3 hours, the IRDAI's 2024 rules are proving effective. The enhanced complaint resolution mechanism further boosts transparency and policyholder convenience. 

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