Hyderabad::
The segment regulator IRDAI has asked the insurers to allow telemedicine wherever consultation with a medical practitioner is allowed in the terms and conditions of an insurance policy contract.
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Medical Council of India has issued ‘Tele Medicine practice guidelines’ on 25th of March 2020, enabling registered Medical Practitioners to provide Healthcare using Tele Medicine.
“ Telemedicine offered shall be in compliance with the Telemedicine Practice Guidelines dated 25th of March 2020 and as amended from time to time,’’ said IRDA.
Provision of allowing telemedicine will be part of claim settlement of policy of the insurers and need not be filed separately with the IRDAI for any modification. However, the norms of sub limits, monthly/ annual limits etc. of the product shall apply without any relaxation, said IRDAI .
According to MCI's ‘Tele Medicine practice guidelines there are a number of benefits of telemedicine. It increases timely access to appropriate interventions
including faster access and access to services that may not otherwise be available.
In India, providing In-person healthcare is challenging, particularly given the large geographical distances and limited resources. One of the major advantages of telemedicine can be for saving of cost and effort especially of rural patients, as they need not travel long distances for obtaining consultation and treatment.
With telemedicine, there is higher likelihood of maintenance of records and documentation hence minimalizes the likelihood of missing out advice from the doctor other health care staff. Conversely, the doctor has an exact document of the advice provided via tele-consultation. Written documentation increases
the legal protection of both parties.
Telemedicine provides patient’s safety, as well as health workers safety especially in situations where there is risk of contagious infections. There are a number of technologies that can be used in telemedicine, which can help patients adhere better to their medication regimens and manage their diseases better. Telemedicine can also enable the availability of vital parameters of the patient available to the physician with the help of medical devices such as blood pressure, blood glucose, etc management.
it is well suited for disasters and pandemics scenarios in which medical practitioners can evaluate and manage patients. A telemedicine visit can be conducted without exposing staff to viruses/infections in the times of such outbreaks.Telemedicine practice can prevent the transmission of infectious diseases reducing the risks to both health care workers and patients.
Unnecessary and avoidable exposure of the people involved in delivery of healthcare can to be avoided using telemedicine and patients can be screened remotely. It can provide rapid access to medical practitioners who may not be immediately available in person. In addition, it makes available extra working hands to provide physical care at the respective health institutions.
Thus, health systems that are invested in telemedicine are well positioned to ensure that patients with Covid-19
kind of issues receive the care they need.
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Meanwhile, the insurance regulator has asked all general and health insurers rendering health services both through Third Party Administrator (TPA)and/or in-house to make the captioned TPA wise public disclosures in the format designed by the authority.
The information has to be published within a period of ninety days after the close of every financial year.
The policyholders desirous of knowing the details can access all the above information on visiting the website of respective insurer or the TPA.
Insurers have to comply with the new norms with immediate effect and data as at 31st March, 2020 shall be published by 30th September, 2020.
In case of termination of services of a TPA, the insurer has to publish the same in its website along with the reasons for termination within three days from the effective date of termination.
The data in the specified format will have to l be duly signed by either CEO or one of the Whole Time Directors of the Insurer.
All TPAs have to provide the link of every insurance company where the said information is available. The link shall be made available in respect of the insurers with whom the TPA had a service level agreement, said the IRDAI.
All TPAs have also to provide the requisite data or information to the insurers, wherever called for, in order to enable insurers publish the above information in their respective websites, said the IRDAI.