Supreme Court Quashes Rajasthan Village Renaming, Says Government Must Follow its Own Policy  ||  NCLAT: NCLT Can Order Forensic Audit on its Own, No Separate Application Required  ||  NCLAT Reiterates That IBC Cannot be Invoked as a Recovery Tool for Contractual Disputes  ||  Delhi HC: DRI or Central Revenues Control Lab Presence in Delhi Alone Does Not Confer Jurisdiction  ||  Delhi High Court: Software Receipts Not Taxable on PE Basis Already Rejected by ITAT  ||  Delhi High Court: Statutory Appeals Cannot Be Denied Due to DRAT Vacancies or Administrative Delays  ||  J&K&L HC: Failure to Frame Limitation Issue Not Fatal; Courts May Examine Limitation Suo Motu  ||  Bombay HC: Preventing Feeding Stray Dogs at Society or Bus Stop is Not 'Wrongful Restraint'  ||  Gujarat HC: Not All Injuries Reduce Earning Capacity; Functional Disability Must Be Assessed  ||  Delhi HC: Framing of Charges is Interlocutory and Not Appealable under Section 21 of NIA Act    

Communication on settlement of health insurance claims against General Insurance Council's instructions dated 20th June 2020 on "Reference, Rates for COVID-19"- (Insurance Regulatory and Development Authority) (13 Jan 2021)

MANU/IRDA/0003/2021

Insurance

1. Attention is drawn to the Circular ref: "Reference rates for COVID-19 treatment" dated 20th June 2020 issued by General Insurance Council [GIC].

2. In case of "Cashless Claims" under a health insurance policy, 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 shall 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. Also, while entering into such agreements, the reference rate of GI council can be kept in view for guidance alongwith rates fixed by State Governments and Union Territory administration, if any and as relevant.

3. All the insurers are directed to ensure that the "Reimbursement claims" under a health insurance policy shall be settled as per the terms and conditions of the respective policy contract. Hence, the insurers shall honor all the health insurance claims as per the terms and conditions of the policy contract.

4. Insurers are advised to issue suitable guidelines on this to all TPAs.

5. This has the approval of Competent Authority.

Tags : COMMUNICATION   SETTLEMENT   INSURANCE CLAIMS  

Share :        
2. In case of ""Cashless Claims"" under a health insurance policy, the claims shall be settled as per the tariff decided by the parties in c... For read more news from newsroom.manupatra.com"data-action="share/whatsapp/share" class="ic_wtsp-grid">

Disclaimer | Copyright 2025 - All Rights Reserved