IRDA asks Insurers to settle claims related to COVID-19

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, including vector borne diseases. "For the purpose of meeting health insurance requirements of various sec tions, insurers are advised to design products covering the costs of treatment for coronavirus," the Irdai said in a circular.

The regulator said that under existing health insurance policies where hospitalisation is covered, not only the cases related to coronvirus disease (COVID-19) shall be expeditiously handled, but all the costs of admissible medic al expenses during the course of treatment, including the treatment during quarantine period, should be settled in accordance to the applicable terms an d conditions of policy contract and the extant regulatory framework.

This would bring much needed relief to policy holders some of whom were facing difficulty in getting coverage for treatment takers to coronavirus. In th e absence of clear information, a few hospitals were reportedly denying for 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.

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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.