People have always been health conscious and it was just a part of their routine then. But now, in such a rampant pandemic, being healthy has become a need for survival. The Government of India has taken feasible steps to resist the dissemination. Nevertheless, there is still a widespread disease, and here comes the entry of health insurance.
As this lethal virus outspread around the globe the expenditure for medication is being a burden. Health insurance helps to reduce the cost of medical expenses disbursed by an individual for the sake of oneself and their dearest ones. Health insurance is like a derivative to hedge a risk of exposure to communicable diseases.
After the COVID-19 epidemic, the IRDAI has taken the necessary steps and provided recommendations to insurance providers to ensure a seamless premium payment process for health insurance policyholders. The new recommendations on the resolution of COVID-19 insurance cases at ‘make-shift or emergency clinics’ have been given to insurers.
In its report, IRDAI asserts that it is necessary to consider the make-shift or temporary hospitals allowed by the government to resolve health insurance claims for insurance firm’s insight of a rise in the number of COVID-19 cases and in order to leverage the current healthcare programs systems in place.
Thus, in this context and to ensure that the treatment costs of COVID – 19 are protected in compliance with the terms and conditions of the insurance contract, a make-shift or temporary hospital approved by the federal or state government shall be treated as a hospital or network provider and insurers shall resolve the claims in accordance with the following norms:
- Where, on the recommendation of a medical practitioner or competent government authority, a policyholder who is diagnosed as Covid-19 positive is admitted to some other make-shift or temporary hospital, ignoring the concept of the hospital stated in the terms and conditions of the policy contract, the costs of care shall be covered by insurers.
- Any network provider has built some other make-shift or temporary hospital, other make-shift or temporary hospital shall be treated as the network provider extension, and cashless facilities shall be made available.
