Health insurance companies can no longer deny claims, deduct charges for specific Covid treatment

IRDAI has advised the health insurance providers to take appropriate action for ensuring that the claims are settled as per terms and conditions of the policy.

insurance, health insurance, insurance claims, Covid-19, Covid treatment, Antibody Cocktail therapy, IRDAI, experimental treatment, Corona Kavach, Corona Rakshak
As the Antibody Cocktail therapy was first started on experimental basis, many health insurance companies were either denying the claims on such treatments or were deducting the cost of the antibody cocktail.

As no specific medicine was available to treat the Covid-19 patients, after trying various antibiotics, doctors started administering “Antibody Cocktail therapy” to treat such patients. As the therapy was first started on experimental basis, many health insurance companies were either denying the claims on such treatments or were deducting the cost of the antibody cocktail (mainly containing Casirivimab and Imdevimab).

However, the Central Drugs Standard Control Organisation (CDSCO) gave emergency use authorisation (EUA) to the use of antibody cocktail (Casirivimab and Imdevimab) in May, 2021 in our country.

So, after coming across the instances of denial of claims and / or deduction of expenses incurred towards “Antibody Cocktail therapy” treatment for Covid-19, under the pretext that the said therapy is an experimental treatment, the Insurance Regulatory and Development Authority of India (IRDAI) has advised the health insurance providers to review the claims denied/deductions made in such claims and take appropriate action for ensuring that the claims are settled as per terms and conditions of the policy.

The insurance regulator has also requested the health insurance companies to put in place effective claim settlement procedures to update the developments/approvals given by relevant authorities so that all claims are settled as per the terms and conditions.

So, the health insurance companies would no longer be able to deny claims or deduct charges for the “Antibody Cocktail therapy” used to treat Covid patients.

During the onset of the pandemic also, the IRDAI came down heavily on health insurance providers after they started denying claims related to Covid-19, citing its pandemic status.

The insurance regulator not only asked the health insurers to settle the claims related to Covid-19, but also asked the insurers to issue two Covid-specific insurance products with standard features.

Following which, the health insurance companies had launched Corona Kavach and Corona Rakshak policies to provide widespread insurance cover against the Covid-19 at a cheaper rate compared to a full-fledged health insurance policy.

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