The Insurance Regulatory and Development Authority of India (IRDAI) wants insurers to expeditiously handle hospitalisation claims pertaining to COVID-19.
“Where hospitalisation is covered in a product, insurers shall ensure that the cases related to coronavirus disease (COVID-19) shall be expeditiously handled,” the regulator said. On Wednesday, it issued guidelines for handling such claims, which came into immediate effect.
Also read | COVID-19 cases rise to 29 in India | COVID-19: Full coverage
The costs of medical expenses during the course of treatment, including the treatment during quarantine, should be settled in line with the applicable terms and conditions of the policy contract and the extant regulatory framework, general manager (Health), D.V.S. Ramesh said in the circular.
The IRDAI also advised the companies that all the claims ought to be “thoroughly reviewed by the claims review committee before repudiating them.” Noting that insurers are introducing products for various specific diseases, including vector-borne diseases, it urged them to design products covering the costs of treatment for COVID-19.
Senior executives of insurance companies also issued statements on COVID-19 claims.
SBI General Insurance Head-Underwriting and Reinsurance Subramanyam Brahmajoysula said, “Claims due to coronavirus are payable, provided the person concerned is hospitalised for at least 24 hours. Most of the health insurance policies in India do not cover outpatient treatment. However, if coronavirus is declared a pandemic by the WHO or the Indian government, claims might not be payable as such claims are excluded under many health insurance policies.”
Brakes on travel cover
Travel cover is a segment of insurance business that has started feeling the heat of the coronavirus outbreak.
Also read | SEBI says gauging virus impact
Bajaj Allianz General Insurance Head-Retail Underwriting Gurdeep Singh Batra said travel insurance off-take had slowed down as travel itself had slowed down. “Everybody is cutting down on travel, including domestic,” he said in response to questions on the impact on insurers.
As for the travel restrictions issued by government, he said that whenever such an advisory was issued, those travelling to the specified countries were not covered for risks associated with the disease.
Explained: When can people transmit the novel coronavirus? | Watch: COVID-19 — Dos and don'ts from the Health Ministry
