Wednesday, January 20, 2021
Home Asia IRDAI forms advisory panel on health cover

IRDAI forms advisory panel on health cover

Insurance regulator IRDAI has constituted a health insurance advisory committee to examine the availability of products, suggest approach on the coverage of specific diseases, and develop a strategy on treatment protocol or rate structure towards improving affordability of the insurance.

The 10-member committee comprising experts and specialist doctors has been also tasked with examining the extant health insurance product structure in terms of policy conditions to protect the interest of the policyholders. The committee will have the IRDAI chairman and member (non-life) as its chairperson and vice-chairperson, respectively. It will examine the availability of health insurance products in the country in the light of the need of Indian society, and recommend suitable products and processes.

According to the order, constituting the committee, the panel will have a tenure of one year and its terms of reference include suggesting approach on coverage of specific disease or an area of practice (e.g cardiology). Figuring in the committee are doctors from the public and private healthcare sector, including those in senior administrative positions as well a homeopathic physician.

The formation of the committee comes in the backdrop of a increased demand for health insurance since the outbreak of COVID-19 pandemic. On its part, the regulator last year had issued guidelines on standardised health insurance products and also directing insurers to offer standardised products for COVID-19.

Advice TPAs

Separately, in a circular on Wednesday, the regulator cited a June 2020 General Insurance Council communication on reference rates for COVID-19 treatment and advised insurers to issue suitable guidelines on this to all TPAs.

All the insurers are directed to ensure the reimbursement claims under a health insurance policy will be 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.

In case of cashless claims, the claims shall be settled as per the tariff decided by the parties in compliance to provisions of Regulation 31 of IRDAI (Health Insurance) Regulations, 2016. However, the insurers need to 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, IRDAI General Manager (Health) D.V.S. Ramesh said in the circular.

You have reached your limit for free articles this month.

Subscription Benefits Include

Today’s Paper

Find mobile-friendly version of articles from the day’s newspaper in one easy-to-read list.

Unlimited Access

Enjoy reading as many articles as you wish without any limitations.

Personalised recommendations

A select list of articles that match your interests and tastes.

Faster pages

Move smoothly between articles as our pages load instantly.


A one-stop-shop for seeing the latest updates, and managing your preferences.


We brief you on the latest and most important developments, three times a day.

Support Quality Journalism.

*Our Digital Subscription plans do not currently include the e-paper, crossword and print.

Source link

Most Popular

Air India, BPCL disinvestment hits COVID, oil price hurdles

The coronavirus pandemic and crash of crude prices have considerably delayed the disinvestment plan of the government that targeted to raise about Rs...

Insurance awareness, ownership show progress in Covid times: Max Life’s Survey

The ongoing pandemic situation has accelerated the knowledge and ownership of insurance in the country, and this is reflected in the findings of...

Expectations From Budget 2021 From Personal Finance Of A Common Man’s Perspective

<!-- -->A higher deduction under section 80C to avail tax deduction will be a welcome relief.An increase in the income tax bracket is...

7 reasons why your insurer is making you bear hefty medical bills

Some hospitals may charge more for expenses that are not a part of your health insurance policy. Thus, insurers may only settle claims...

Recent Comments