Tuesday, Aug 09, 2022

Health Insurance Policies Will Cover Omicron Treatment Also, Clarifies IRDAI

All health insurance policies issued by general and health insurers that cover Covid-19 treatment will also cover Omicron-related treatment, the insurance regulator has clarified.

In the wake of increasing instances of Covid-19 cases being reported under the Omicron variant, insurance regulator,  Insurance Regulatory and Development Authority of India (Irdai), has clarified that all health insurance policies issued by all general and health insurance companies that cover treatment costs of Covid-19 also cover the costs of treatment towards the Omicron variant of Covid-19 as per terms and conditions of policy contract, according to a press release issued on Tuesday, January 3, 2022, by the regulator.  

Earlier, in another press release issued on April 1, 2020, Irdai had said that all the indemnity-based health insurance products that cover the treatment costs of hospitalisation offered by the general and health insurance companies cover the costs of hospitalisation treatment on account of Covid-19.  

“Irdai’s new guideline, issued in the wake of infections caused by the new variant, is an initiative to provide complete benefits of the health insurance plan to the policyholders. The regulator has been quite instrumental during this pandemic where it has introduced standard Covid-19 specific policies and included Covid treatment under all health insurance plans. The new notification is on similar lines of customer service. As this is only a new variant of the same Covid-19, the guidelines stated earlier remain the same. And health insurance companies are guided to follow the terms and conditions as stated in their policies for any other treatment without putting any special condition,” says Naval Goel, CEO and founder, PolicyX.com, an insurance web aggregator.  

The insurance regulator has instructed all insurance companies to put in place effective co-ordination mechanism with all their network providers (hospitals) for the purpose of making available seamless cashless facility to all policyholders in case of hospitalisation if any and render speedy services to all policyholders.  

Irdai has also requested hospitals to honour the service level agreements (SLA) that they have with insurance companies for providing cashless treatment to health insurance policyholders.  

Irdai has provided this clarification to assure policyholders and ensure that they do not face any issues if they need to seek treatment for Omicron-related infection.