The Insurance Regulatory and Development Authority of India (IRDAI) has asked non-life insurers to settle Covid-19 claims even if the patient is admitted in makeshift or temporary hospitals recognised by the government.
In a circular, the insurance regulator told the general insurers that the makeshift or temporary hospitals permitted by central and state governments shall be considered as a hospital or a network provider.
As a result, any person who tests positive for coronavirus and has been advised by a doctor or a government to get admitted in a makeshift or temporary hospital then the cost of treatment for the policyholder will be settled by the insurers.
The IRDAI said even when a hospital or a network provider sets up a makeshift or temporary facility to treat Covid-19 patients then that facility will be considered as an extended facility and cashless treatment facility be provided to the policyholder.
“Where a policyholder who is diagnosed as Covid-19 positive is admitted into any such make-shift or temporary hospital on the advice of a medical practitioner or appropriate Government authorities, notwithstanding the definition of hospital specified in the terms and conditions of policy contract, the treatment costs shall be settled by insurers,” the notice said.
Recently the IRDAI had asked insurers to take action against hospitals that decline cashless treatment facility for Covid-19 to policy holders.
Citing complaints against such hospitals' refusal despite their agreements with insurers and claims processing agencies, the IRDAI has asked insurers to make complaints to the appropriate government agencies in different states.
The IRDAI also asked the insurers to publish the action taken on the complaints against hospitals on their website.
The General Insurance Council had recently come out with a standardised rate for hospitals to charge for Covid-19 treatment.
Industry officials told IANS that big corporate chain hospitals were not agreeable to the rates.
The hospitals feel that this will not be the last time the insurers come up with a standardised rates, and may later come out with rates for other treatment procedures as well.