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Cashless claim approval time: your 1-hour and 3-hour rights

Cashless means the insurer settles the hospital directly, so you don't pay upfront and claim later. IRDAI's 2024 Master Circular put firm clocks on it — if you know the timelines, you can push back when a hospital says approval is 'still pending'.

Your 1-hour / 3-hour rights

Under the Master Circular on Health Insurance Business (29 May 2024), the insurer must decide a cashless authorisation request within 1 hour of receiving it, and grant final authorisation for discharge within 3 hours of the hospital's request. These are norms the insurer owes you, not favours.

"Cashless Everywhere"

Separately, the General Insurance Council announced "Cashless Everywhere" on 24 January 2024 — an industry initiative (not an IRDAI regulation) that lets you use cashless even at non-network hospitals meeting basic criteria (broadly, registered hospitals with at least 15 beds). Intimation is expected roughly 48 hours ahead for planned admission, or within 48 hours for an emergency. Because it's an initiative and not a rule, confirm your insurer participates before relying on it.

If cashless is refused

A cashless denial is not a claim denial — you can still pay and claim reimbursement. Under IRDAI's 2024 policyholder-protection framework, the insurer must ask for all required documents at once (not in piecemeal demands), must state the specific policy-clause reason for any deduction or disallowance, and owes interest at the bank rate plus 2% if it settles late.

General guidance — verify with your insurer and policy wording. Sources: IRDAI Master Circular on Health Insurance Business, 29 May 2024; IRDAI (Protection of Policyholders' Interests) Regulations 2024 & Master Circular on PPI, 5 Sep 2024; General Insurance Council 'Cashless Everywhere', 24 January 2024.

Frequently asked

How fast must the insurer approve cashless?

Under IRDAI's 29 May 2024 Master Circular, the insurer must decide a cashless request within 1 hour, and grant final authorisation for discharge within 3 hours of the hospital's request.

Is 'Cashless Everywhere' a legal right?

No. It's a General Insurance Council industry initiative announced on 24 January 2024, not an IRDAI regulation. Confirm your insurer participates before relying on it at a non-network hospital.

Cashless was refused — is my claim over?

No. You can still pay and file for reimbursement. The insurer must request all documents at once, must give the specific policy-clause reason for any deduction, and owes bank-rate + 2% interest for late settlement under IRDAI's 2024 rules.

IRDAI Master Circular on Health Insurance Business, 29 May 2024; IRDAI (Protection of Policyholders' Interests) Regulations 2024 & Master Circular on PPI, 5 Sep 2024; General Insurance Council 'Cashless Everywhere' press release, 24 January 2024 · As of 2026-07-02