IRDAI issues Circular on Corona Virus under Health Policies

In the backdrop of coronavirus across the world and reporting of 28 cases of coronavirus infected in India, the Insurance Regulatory and Development Authority of India (IRDAI) has recently issued a set of guidelines to be followed by the insurance companies in settlement of claims arising under Coronavirus.

The IRDAI’s direction to insurance companies to entertain health insurance claims swiftly has come up as a huge relief for policyholders.

The regulator has also asked insurers to design products covering the costs of treatment for Corona Virus similar to products introduced by them for various specific diseases including vector-borne diseases.

Read the full text of the Guidelines on handling of claims reported under Corona Virus issued by IRDAI on 04.03.2020.

Circular

Ref. No: IRDAI/HLT/REG/CIR/054/03/2020 Date: 04-03-2020

Guidelines on handling of claims reported under Corona Virus

Ref: IRDAI/HLT/REG/CIR/054/03/2020 04th March, 2020 To All Insurers (except ECGC, AIC) Re: Guidelines on handling of claims reported under Corona Virus 1.    In respect of the products filed and cleared as per the provisions of Guidelines on product filing in Health Insurance Business (Ref: IRDA/HLT/REG/CIR/150/07/2016) dated 29th July 2016, where coverage is granted for treatment of hospitalization expenses, in order to alleviate the hardships that may be caused to the policyholders, all claims reported under corona virus shall be handled as per the following norms.      i)      Where hospitalization is covered in a product, insurers shall ensure that the cases related to Corona virus disease (COVID-19) shall be expeditiously handled.     ii)        The costs of admissible medical expenses during the course of treatment including the treatment during quarantine period shall be settled in accordance to the applicable terms and conditions of policy contract and the extant regulatory framework.    iii)        All the claims reported under COVID 19 shall be thoroughly reviewed by the claims review committee before repudiating the claims. 2.    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 Corona Virus. 3.    These instructions are issued under the provisions of Section 14 (2) (e) of IRDA Act, 1999 and shall come in to force with immediate effect. 4.    This has the approval of the competent authority. (D V S Ramesh) General Manager (Health)

Download Copy of Guidelines on handling of claims reported under Corona Virus issued by IRDAI in pdf format.

Note:

Even though this is a blog related to tax topic, however, due to the widespread effect of Corona Virus across the world including India, the regulatory guidelines are published for the benefit of the readers. Everyone must be anxious to know whether the treatment of coronavirus is covered in the Health Insurance or mediclaim policy or not. Hence, the regulatory clarification is posted for general awareness. 

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