INSURANCE
IRDAI asks insurers to settle claims for treatment at make-shift COVID-19 hospitals
Jul-17-2020

In a relief to policy holders, the Insurance Regulatory and Development Authority of India (IRDAI) has asked general and health insurers to settle claims for treatment at make-shift or temporary hospitals set up for COVID-19 patients. In view of the increasing number of coronavirus cases, several state governments have set up make-shift or temporary hospitals. The number of coronavirus cases is rising rapidly and is expected to soon cross 1 million mark in the country.

The regulator said when 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. It further added that where any network provider has set up any such make-shift or temporary hospital, such make-shift or temporary hospital shall be regarded as the extension of the network provider and cashless facility shall be made available.

The regulator also directed general and health insurers to expedite settlement of all such claims in accordance to the applicable regulatory framework. The insurers have also been advised to incorporate the above norms in claim guidelines and inform all the third-party administrators (TPAs) immediately.

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