New Delhi: The Insurance Regulatory and Development Authority of India (IRDAI) on Wednesday asked insurers to expeditiously settle hospitalisation claims related to coronavirus disease under health policies. It also asked insurance companies to come out with policies to cover treatment costs for coronavirus infection, which has impacted thousands of people worldwide.
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 sections, insurers are advised to design products covering the costs of treatment for coronavirus," Irdai said in a circular. There are 28 confirmed cases of coronavirus infection in India.
IRDAI has asked insurers to expeditiously attend to claims for treatment of coronavirus.
"Where hospitalisation is covered in a product, insurers shall ensure that the cases related to coronvirus disease (COVID-19) shall be expeditiously handled," it said.
Also, 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.
"All the claims reported under COVID-19 shall be thoroughly reviewed by review committee before repudiating the claims," the circular added.
Over six lakh people have been screened for novel coronavirus at 21 airports. Also more than 10 lakh incoming people at India's open borders with Nepal, Bhutan and Myanmar have been screened as well.
Commenting on IRDAI's directives, Subramanyam Brahmajoysula, Head (Underwriting and Reinsurance) of SBI General Insurance said claims due to coronavirus are payable provided the concerned person is hospitalised for at least 24 hours.
"Most of the health insurance policies in India do not cover outpatient treatment. However, if corona virus is declared as a pandemic by WHO or Indian government, then claims might not be payable as such claims are excluded under many health insurance policies," said Brahmajoysula.
Ashish Mehrotra, MD and CEO of Max Bupa Health Insurance, said any policyholder hospitalised for coronavirus condition will be insured under "our hospitalisation policies" and the company will expedite claims for the treatment.
However, the insurers are silent on whether they would be settling claims if a patient is being quarantined.
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