Hyderabad:
In view of increase in number of COVID-19 cases in the country,the insurance regulator IRDAI has said, with immediate effect, any Covid -19 claims out of treatments in the the make-shift or temporary hospitals permitted by Government,have to be paid by the insurers.
In order to ensure that the costs of treatment of COVID – 19 are covered as per the terms and conditions of policy contract, a make-shift or temporary hospital permitted by Central / State government will be also regarded as a hospital or network provider and insurers have to settle the claims, said IRDAI on Thursday.
The IRDAI has laid down specific norms and has asked all the insurers to incorporate them in claim guidelines and inform to all the TPAs immediately
-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 has to be settled by insurers,
-Where any network provider has set up any such make-shift or temporary hospital, such make-shift or temporary hospital will be regarded as the extension of the network provider and cashless facility shall be made available,.
Insurers have been advised by the IRDAI to expedite settlement of all such claims in accordance to the applicable regulatory framework.