IRDAI allows home treatment as add-on cover in health insurance

Norms for settlement of claims should be mentioned in the policy document and prospectus: IRDAI

The Indian insurance regulator IRDAI has allowed non-life insurers to offer "homecare/domiciliary treatment" or treatment at home as an add on cover afresh or to their existing policies.

In a circular to all non-life insurers including standalone health insurers, the Insurance Regulatory and Development Authority of India (IRDAI) has said companies have to file their products with it, if home treatment is offered as an add-on cover.

According to IRDAI, homecare treatment is one taken at home for an ailment that normally needs hospitalisation provided that a medical practitioner advises the insured home treatment; there is a continuous active line of treatment with the health status of the insured monitored daily by a medical practitioner during the duration of home treatment; and that records of daily monitoring of the insured patient and the treatment given are recorded and signed by a medical practitioner

Norms for settlement of claims should be mentioned in the policy document and prospectus, it said.

IRDAI said that insurers can offer the cover to their existing policyholders by charging an additional premium for the residual period of time.

Reacting to the development, Liberty General Insurance Ltd's CEO and Whole Time Director Roopam Asthana told IANS that the "add-on cover has to be priced right taking into account the data and possible scenarios".

Though the insurers will save on huge daily hospital room charges, the doctor and nurse fee may be on slightly on the higher side then what a hospital charges.

Industry officials told IANS the add-on cover would have been beneficial when Covid-19 pandemic was at its peak and hospital beds were not available, but now the situation is not that serious.

However, it is also true that how the pandemic will pan out in the future is not known.

A senior industry official, who preferred anonymity, told IANS that the coverage should be priced taking into account payments made towards renting hospital beds and other medical equipment that are normally used in a hospital room.

--IANS

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