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Surabhi
With the rapid spread of novel coronavirus leading to soaring medical bills for many patients, general insurance companies are now working with hospitals and TPAs to arrive at standard treatment costs for the infection.
Sources close to the development said the Insurance Regulatory and Development Authority of India (IRDAI) has asked industry body General Insurance Council to arrive at standardised rates for treatment of Covid-19 in about a month’s time.
“The IRDAI has asked general insurers and TPAs to discuss with hospitals and arrive at common standardised rates. Much depends on the cooperation from the hospital management,” said an executive with an insurance company.
“We will have to get in touch with all hospitals. It can be done only by TPAs. It is a mammoth and not-so-easy task. Co-morbidity will change the whole scenario. A young man with no other problems but only Covid-19 will have a different treatment, but a patient with other complications will require intensive treatment. The rates will be different and will vary from hospital to hospital as well as place to place,” said another general insurer.
Hospitalisation charges
In some cases, hospitalisation charges for Covid-19 patients have run into more than ₹12 lakh to ₹13 lakh due to the requirement of ICU treatment and ventilators. On average, claims for Covid-19 hospitalisation have been at ₹2 lakh per policy holder. About 7,000 claims have been filed till date.
General insurance and standalone health insurance companies had earlier asked the government to consider standardisation of rates for procedures and issue package rates.
The GIC had previously also has written to the Ministry of Health and Family Welfare to look into the issue to intervene in the issue.
Sources said that while their earlier representation did not get a response, the IRDAI has now asked the industry to resolve the issue.
Apart from facilities such as testing and special isolation wards, patients often also require intensive care unit and ventilator support for treatment. According to insurers, the payout for a Covid-related claim is at least two-and-a-half times more than of any other communicable disease.
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