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With more and more infected cases of Covid-19 flocking into specialty hospitals, the number of health insurance claims are increasing by the day. Apart from the health of the patient, people are concerned about the treating cost of coronavirus, which is still unknown as there is no sure-fire treatment available.  Doctors across the world are trying different measures to treat Covid-19 patients like using medicines used in the treatment of common cold, flu or HIV, etc.

IRDAI issues instructions regarding COVID-19 treatment cost claim settlement

As per a recent announcement made by IRDAI, the insurance companies should settle the cases of insurance claims for the treatment of coronavirus as per the steps laid down for regular health insurance claims. Along with this, IRDAI has also asked insurance companies to hasten the process of claim settlement to ensure immediate relief to the affected people.

The key announcements by IRDAI:

  1. To settle COVID-19 claims on the same guidelines as a regular medical insurance claim prescribed under the subscribed insurance policy
  2. To design and develop insurance products attending to coronavirus treatment requirements
  3. To accord with the quarantine costs, hospitalization costs, medical expenses as per the regular health insurance policy under the provisions and terms and conditions of the subscribed insurance policy.

If a patient is detected to be coronavirus positive and already holds a health insurance policy, then he or she can claim the settlement of treatment cost under the same policy. However, there are certain conditions that need to be fulfilled to ensure the patient gets complete coverage.

These are:

  1. There should be a minimum hospitalization period of 24 hours to claim the settlement. Since almost all insurance policies cover only the in-hospitalization costs, this is a mandatory requirement. No out-hospital charges will be covered.
  2. If the World Health Organization declares coronavirus outbreak to be a pandemic or epidemic, then none of the insurance claims on account of coronavirus will hold true. There are separate provisions in case of a pandemic or epidemic.
  3. In case the patient already had planned for a respiration-related treatment and is detected as coronavirus positive, before or after the purchase of the policy, then also the health insurance policy will not hold true.
  4. If the policyholder happens to get contracted by coronavirus within the waiting period.

Conclusion

All insurance companies are strictly following the guidelines laid by IRDAI and expediting the claim settlement process for affected people.

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