Finance Minister instructed IRDAI to take steps for denying health insurance claims

Finance Minister instructed IRDAI to take steps for denying health insurance claims

On 22nd April, Minister of Finance of India Nirmala Sitharaman stated that after a few Coronavirus patients were denied compensatory medical coverage claims by hospital administration and insurance agencies and instructed the IRDAI to determine the issue at the soonest. The IRDAI has asked insurance agencies to focus on the accommodation of cashless health insurance claims.

Nirmala Sitharaman further stated that “Starting at 20th April, more than nine lakh coronavirus related health insurance claims have been agreed by insurance agencies for 8,642 Crore rupees. Indeed, even teleconsultations can be covered in this scheme. The Insurance Regulatory Development Authority of India will guide organizations to focus on approvals and settlements of health insurance claims.”

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Star Health Insurance’s director Dr. S Prakash stated that “Prior out of the total number of health claims, around 20 percent to 30 percent medical coverage claims were of Coronavirus patients. Yet, after this 2nd Covid wave hit the nation around half of the health claims are coming from Coronavirus patients. The circumstance is troubling and awkward for the organization. We are running into immense losses yet we are as yet attempting to settle a most extreme number of real cases coming from Coronavirus patients”.

Additionally, ManipalCigna Insurance Company’s COO Priya Deshmukh stated that with a flood in Coronavirus cases the organization might want to guarantee its policyholders that it is focused on focusing on the evaluation of cases identified with the treatment of Coronavirus and will be claimable to the full degree of the claim accessible under their insurance plans designs according to the terms and conditions of the insurance”.

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The Insurance Regulatory Development Authority of India stated that “Taking perception of reports that a few hospitals are not allowing cashless provision for treatment of Coronavirus notwithstanding health claims being qualified for the cashless treatment under their health insurance and also back up plans to have a course of action with the hospitals for giving cashless provision.

“Every hospital who have consented to SLA with general and health insurance firm need to obligatorily give the cashless provision for any treatment to the policyholders incorporating Coronavirus treatment as per concurred arrangements of Service Level Agreements”.

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