Regulator IRDAI has asked insurers to settle all claims related to coronavirus expeditiously under existing health policies that provide for treatment of hospitalisation expenses. It has also asked insurers to design products covering the cost of treatment of coronavirus that has fast spread across the world and also resulted in increasing number of infections in India. There has been over 3,000 deaths globally and 58 cases tested positive in India.
In order to provide need-based health insurance coverage,insurers are introducing products for various specific diseases, includingvector borne diseases. “For the purpose of meeting health insurancerequirements of various sections, insurers are advised to design productscovering the costs of treatment for coronavirus,” the Irdai said in a circular.
The regulator said that under existing health insurancepolicies where hospitalisation is covered, not only the cases related to coronavirusdisease (COVID-19) shall be expeditiously handled, but all the costs ofadmissible medical expenses during the course of treatment, including thetreatment during quarantine period, should be settled in accordance to theapplicable terms and conditions of policy contract and the extant regulatoryframework.
This would bring much needed relief to policy holders some ofwhom were facing difficulty in getting coverage for treatment for coronavirus.In the absence of clear information, a few hospitals were reportedly denyingfor forward such claims of policy holders to the insurers.
IRDA has now said that all the claims reported under COVID-19 shall be thoroughly reviewed by review committee before repudiating the claims. This would prevent blanket rejection of such claims. But to get full claim for treatment of coronavirus, industry experts said, a person should be hospitalised at least for 24 hours. Most insurers do not cover outpatient treatment.