The Insurance Regulatory and Development Authority (IRDAI) issued new guidelines on the settlement of insurance claims on treatment received for COVID-19 at 'make-shift or temporary hospitals,' as permitted by the government.
The regulatory authority said that in order to ensure that the costs of treatment of COVID-19 are covered as per the terms and conditions of policy contract, a make-shift or temporary hospital permitted by central/state government shall be regarded as a hospital or network provider.
A policyholder, who is diagnosed with COVID-19 and is admitted into any make-shift or temporary hospital permitted by central/state government on the advice of a medical practitioner or appropriate government authorities, notwithstanding the definition of hospital specified in the terms and conditions of policy contract, can claim for the treatment costs with insurers.
If the make-shift or temporary hospital has been set-up by any network provider, such a place shall be regarded as the extension of the network provider and a cashless facility shall be made available there.
"In order to leverage on the extant healthcare systems put in place, it is important to recognize the make-shift or temporary hospitals permitted by the Government for settlement of health insurance claims for insurance companies," the IRDAI said.