Coronavirus Outbreak: Expeditiously attend to claims, IRDAI asks insurers

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March 11, 2020 6:16 PM

To alleviate the hardships that policyholders may face to get Coronavirus claims settled, the insurance regulator has issued guidelines to health insurance companies.

Coronavirus Outbreak, COVID-19, health insurance, Insurance Regulatory and Development Authority of India, IRDAI, hospitalisation expenses, insurance claimsAll the claims reported under COVID-19 shall be thoroughly reviewed by the clais review committee before repudiating the claims.

With the spike in confirmed Coronavirus (COVID-19) cases reported in India, the Insurance Regulatory and Development Authority of India (IRDAI) has asked insurers to expeditiously attend to claims for treatment of Coronavirus.

To alleviate the hardships that policyholders may face to get Coronavirus claims settled, the insurance regulator has issued guidelines to health insurance companies and instructed them that the costs of admissible medical expenses during the course of treatment, including the treatment during quarantine period, should be settled in accordance to the applicable terms and conditions of policy contract and the extant regulatory framework.

According to the guidelines, where coverage is granted for treatment of hospitalisation expenses, all claims reported under Cronavirus shall be handled as per the following norms:

  • Where hospitalisation is coerced in a product, insurers shall ensure hat the cases related to Coronavirus disease (COVID-19) shall be expeditiously handled.
  • The costs of admissible medical expenses during the course of treatment including the treatment during quarantine period shall be settled in accordance to the applicable terms and conditions of policy contract and the extant regulatory framework.
  • All the claims reported under COVID-19 shall be thoroughly reviewed by the clais review committee before repudiating the claims.

Taking note of the guidelines, Prasun Sikdar, MD & CEO, ManipalCigna Health Insurance said, “With the rising number of confirmed and suspected Coronavirus cases, our top priority is the safety and service of our customers, clients, employees and partners. Our comprehensive health insurance plans continue to cover medically necessary treatment associated with Coronavirus or similar such diseases. We would also like to assure our policyholders that we will prioritise the assessment of claims related to the treatment of Coronavirus and will be claimable to the full extent of the coverage available under our health insurance plans as per the terms and conditions of the policy contract.”

As insurers use to introduce products for various specific diseases including vector borne diseases in order to provide need based health insurance coverage, IRDAI has also advised insurers to design products covering the costs of treatment for Coronavirus for the purpose of meeting health insurance requirements of various sections.

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