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Health Insurance

Now cashless health insurance claim for Covid-19 treatments – IRDAI issues new guidelines

The world came to a halt due to sudden Covid-19 outbreak. However, the medical facilities and treatment have been stretched beyond their capability to help and provide optimum treatment to everyone. And people have also become more cautious and careful towards their health and life, leading to more attention towards buying health insurance policies. As when affected with any disease, everyone needs a proper flow of money to get treatment, which is primarily possible with a health insurance plan.

Now cashless health insurance claim for Covid-19 treatments – IRDAI issues new guidelines

Covid-19 is a new disease and thus does not have any norms or guidelines explicitly made to handle it. Social distancing norms, along with office closure and less working capacity in various offices, led to the claim process much slower. In order to tackle these IRDAI has issued new guidelines.

The Insurance Regulatory and Development Authority of India (IRDAI) has further instructed the insurance companies to ensure that the cashless health insurance claims should be settled according to the terms and conditions of the respective policy contract.

The guidelines issued by the IRDAI contain something for every strata of the society, and special care has been taken for the existing health insurance holders. The guidelines include the following:

  1. IRDAI states if the coverage is meant for the treatment expenses to counter all the issues which might experience by the policyholder then all the Covid-19 cases should be taken care of as per the following rules-
  • If the health insurance policy covers the hospitalisation charges, then the insurance providers need to take care that the Covid-19 related cases should be treated with speed and efficiency.
  • The entire cost of treatment and medical expenses including the healing and recovery during the quarantine period should be settled as per the terms and conditions mentioned in the policy and the existing structure set by the apex body IRDAI.
  • The review committee will thoroughly review the claims filed under Covid-19The review committee will thoroughly review the claims filed under Covid-19 before the insurer reject the claims.
  1. With a view to cater to the health insurance sector’s needs, the insurance providers are coming up with unique insurance products, offering coverage for specific diseases. Therefore, the insurers are advised to design such insurance products that cover the cost of the covid-19 treatment. The products need to be developed for all section of the society.
  1. The guidelines that IRDAI issues are under the provisions of the IRDA Act, 1999 – Section 14(2) and are set to come into force immediately.

Overall, IRDAI has been working quite actively to clear the way for dedicated health insurance products against specific disease and ensure that the existing policyholders are covered under their current policies. Health insurance plans, specifically for Covid-19, is vital at this time. However, knowledge of these guidelines is also important to know for the policyholder, such that he or she does not get fooled by anyone.

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