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Treatment at make-shift COVID-19 hospitals eligible for health insurance claims: IRDAI

These guidelines are crucial because there have been complaints about some insurers not recognising hospitalisation treatment availed by COVID-19 patients at make-shift hospitals

Even if there is a make-shift or temporary hospital where you have availed treatment for coronavirus (COVID-19), the insurance company has to pay expenses under health policies.

The Insurance Regulatory and Development Authority of India (IRDAI) said in a circular on July 16 to all general and health insurers that they must recognise claims incurred at that government-recognised temporary hospitals for novel coronavirus, or COVID-19. This is because of the rise in number of COVID-19 cases in India, said IRDAI.

These guidelines are crucial because there have been complaints about some insurers not recognising hospitalisation treatment availed by COVID-19 patients at make-shift hospitals. This is because as per standard insurance definition these temporary units are generally recognised during claims settlement.

According to data from the health ministry, India had total of 9,68,876 confirmed coronavirus cases as of 8 am on July 16. Here a total of 3,31,146 cases are active and there have been 24,915 deaths so far.

Cities like Mumbai and Delhi that have been worst hit by COVID-19 have set up make-shift hospitals to deal with the virus outbreak.

IRDAI said any make-shift or temporary hospital permitted by central or state government will be regarded as a hospital or network provider.

The regulator said where a COVID-19 positive policyholder is admitted into any such make-shift or temporary hospital on the advice of a medical practitioner, the treatment costs shall be settled by insurers.

In cases where any network provider has set up any such make-shift hospital, insurers have to offer cashless facility to policyholders. These guidelines will come into force with immediate effect.

In the recent past, IRDAI has issued guidelines in order to expedite claims settlements for COVID-19 patients.

On July 14, IRDAI had said that all hospitals must provide cashless facility to their network insurers’ customers for treatment of COVID-19 in these medical establishments.

The regulator has also brought out a standard Corona Kavach plan that offers standard treatment for hospitalisation and treatment of coronavirus. -Moneycontrol

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