INSURANCE
Insurers to give 5% discount on ‘Corona Kavach’ premium to doctors, health workers: IRDAI
Jul-15-2020

Insurance Regulatory and Development Authority of India (IRDAI) has asked insurers to give 5% discount on ‘Corona Kavach’ premium to doctors and health workers, and ensure that hospitals do not deny cashless treatment to insured persons in conformity with the terms of policy. As mandated by IRDAI, all the 30 general and health insurers that offer indemnity based health insurance have started offering individual COVID-specific Standard Health Policy called ‘Corona Kavach’. Corona Kavach policies are for three and half months; six and half months; and nine and half months with sum insured ranging from Rs 50,000 to Rs 5 lakhs (in multiples of Rs 50,000).

The regulator said it is aware of reports that some hospitals are not granting cashless facility for treatment of COVID-19 despite such arrangements with the insurers. It further said it has also been brought to the notice of the authority that some of these hospitals are also demanding cash deposits from the policyholders. Therefore, it is clarified that the policyholders are entitled to cashless facility at all network providers (hospitals) with whom the insurance company/TPA has entered into an agreement in accordance to the norms of service level agreements (SLA).

In the event of denial of cashless facility at any such enlisted network providers (hospitals) the aggrieved policyholders can send a complaint to the concerned insurance company. As per the provisions, general and health insurance companies are expected to enter into agreements with public and private sector healthcare providers across the geographical spread. The list of the network providers with whom the insurance company has entered into a service level agreement has to be published on the websites of the insurers and TPAs (Third Party Administrators). IRDAI said where SLAs are entered with hospitals, it is essential for all such hospitals to provide cashless facility for any treatment to the policyholders, including COVID-19 treatment.

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