Ref No: IRDAI/HLT/CIR/MISC/150/7/2022
20th July, 2022
All Insurance Companies and Third Party
Administrators (except ECGC, AIC)
Standards and Benchmarks for the Hospitals in the Provider Network
Reference is invited to IRDAI Circular ref: IRDAI/HLT/REG/MISC/199/07/2021
dated 23rdJuly, 2021 on the captioned subject with respect to the
standards and benchmarks at clause (a)(i) and (ii) and clause (b) of Chapter IV
of the Guidelines on Standardisation in Health
Insurance under Section I of Master circular (ref.
IRDAI/HLT/REG/CIR/193/07/2020 dated 22nd July, 2020).
In partial modification of the above guidelines, in order to
enhance the scope for offering cashless facility across the length and breadth
of the country, the insurers are now empowered to empanel the network providers
that meet the standards and benchmarks criteria as specified by their
respective boards. While specifying the criteria, the board of insurers shall,
amongst others, consider especially the minimum manpower and healthcare infrastructure
The board approved empanelment criteria shall be published in the
website of the insurers from time to time.
While empaneling network providers for cashless facility, insurers
are also advised to focus on the delivery of quality healthcare services.
These instructions shall come in to force with immediate effect.
This circular is issued under the provisions of Regulation 31(e)
of the IRDAI (Health Insurance) Regulation, 2016.
This has the approval of the competent Authority.
मुख्य महाप्रबंधक (स्वास्थ्य)