The insurance regulator on Wednesday issued guidelines to health insurers on how to handle coronavirus claims, and asked firms to design products covering the cost of treatment.
“In order to provide need-based health insurance coverage, insurers are introducing products for various specific diseases including vector-borne diseases. For the purpose of meeting health insurance requirements of various sections, insurers are advised to design products covering the costs of treatment for coronavirus,” said the Insurance Regulatory and Development Authority of India (Irdai).
The regulator has also made it clear that in existing products where the cost of hospitalisation is covered, insurers have to make sure that cases related to coronavirus are dealt with expeditiously.
Moreover, the costs of admissible medical expenses during the course of treatment, including during the quarantine period, shall be settled in accordance to the applicable terms and conditions of policy contract and the extant regulatory framework.
Shreeraj Deshpande, chief operating officer, Future Generali India Insurance, said: “Any person who is hospitalised as a result of coronavirus and takes treatment will be covered as any other illness. The subsequent claims will be processed as per regular norms, provided the individual has been hospitalised for 24 hours. The government has issued advisories on coronavirus infection and the insurance companies will be guided by that.”
Claims should be thoroughly reviewed by the insurers’ claims review committee before repudiating any, the regulator pointed out.
Subramanyam Brahmajosyula, head - underwriting and reinsurance, SBI General Insurance, said, “Claims due to coronavirus are payable provided the concerned person is hospitalised for at least 24 hours. Most of the health insurance policies in India do not cover outpatient treatment. However, if coronavirus is declared as a pandemic by the WHO or the Indian government, then claims might not be payable as such claims are excluded under many health insurance policies.”
Digit Insurance has already come up with a product which will insure a person against the virus, with a maximum coverage of Rs 2 lakh. However, one can choose from multiple sum insured options starting from Rs 25,000, which goes up to Rs 2 lakh.