Insurance Regulatory and Development Authority of India (IRDAI) has mandated the health insurers to decide on the authorisation of cashless treatment to the hospital within two hours from when the request was raised. Through a circular, IRDAI said, “In light of prevailing conditions owing to COVID-19 as also taking into consideration the need for alleviating the pressure on the healthcare infrastructure all the insurers shall decide health insurance claims expeditiously.”
“Decision on authorization for cashless treatment shall be communicated to the network provider (hospital) within two hours from the time of receipt of authorization request and last necessary requirement from the hospital either to the insurer or to the TPA whichever is earlier,” IRDAI added. Last week, the Finance Ministry had extended the renewal dates of motor and health insurance policies that are due between March 25 and May 3 till May 15.
Does Your Health Insurance Policy Cover Coronavirus (Covid 19) Infection?
While most of the health insurance policies cover infection due to Covid-19, you may not be able to get a claim in given conditions.
- If the disease is declared pandemic by WHO or by the Government of India, the insurer may not offer a cover under your health insurance policy.
- When you are hospitalised for less than 24 hours. As most of the health insurance policies do not cover outpatient treatment, if you are not hospitalised for at least 24 hours, the policy may not cover the claim.
- If you are going for a pre-planned respiratory-related disease treatment, your treatment might not get settled under your insurance policy.
- If you get infected with the virus during the policy waiting period, you will not get claim for treatment.
- If you or your family member has travelled to affected countries including China, Hong Kong, Macau, Taiwan, Italy, Kuwait, Japan, Singapore, South Korea, Thailand, etc. and has diagnosed positive, your insurer might not cover the treatment under the policy.
It has nothing to panic about, just pick up your phone and call your insurer if you have any doubts.