COVID-19: IRDAI tells insurers to have agreement with health providers on treatment rates

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New Delhi: Regulator IRDAI has advised general and health insurers to have agreements with health providers on rates for treatment of COVID-19 on the lines of other diseases.

In a circular, the regulator said in case of ‘cashless claims’ under a health insurance policy, the claims should be settled as per the tariff decided by the parties in compliance to provisions of the regulation concerned.

However, the insurers should make efforts to have agreement with health providers on rates for treatment of COVID-19 similar to other diseases for which rate agreements are in place, it said.

“Also, while entering into such agreements, the reference rate of GI (general insurance) council can be kept in view for guidance alongwith rates fixed by State Governments and Union Territory administration, if any and as relevant,” IRDAI said.

It further directed all the insurers to ensure that the ‘reimbursement claims’ under a health insurance policy are settled as per the terms and conditions of the respective policy contract.

“Hence, the insurers shall honour all the health insurance claims as per the terms and conditions of the policy contract,” the circular said.

Earlier, the regulator had asked the insurers to come out with Corona Kavach and Corona Rakshak, standard COVID-19 specific covers.