IRDAI issues guidelines on handling of claims reported under Corona Virus

Mar 19, 2020 | by Avantis RegTech Legal Research Team

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Industry Specific Compliance

The Insurance Regulatory and Development Authority of India (IRDAI) on March 04, 2020, has issued guidelines on handling of claims reported under Corona Virus under the IRDA Act, 1999. IRDAI has covered all the claims reported under corona virus as per the provisions of guidelines on product filing in Health Insurance business, where coverage is granted for treatment of hospitalization expenses, in order to alleviate the hardships that may be caused to the policyholders.

The followings are the norms:-

1. Where hospitalization is covered in a product, insurers shall ensure that the cases related to Corona virus disease (COVID-19) shall be expeditiously handled.

2. 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.

3. All the claims reported under COVID 19 shall be thoroughly reviewed by the claims review committee before repudiating the claims.

In line with the present scenario where insurers are introducing health-based insurance coverage including vector borne diseases, insurers are advised to design products covering the cost of treatment for Corona Virus for various sections.

These instructions shall come in to force with immediate effect.

[Circular No. IRDAI/HLT/REG/CIR/054/03/2020]


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