Supreme Court Rebukes RBI for Remaining a Bystander as YES Bank Operated Clandestinely  ||  Supreme Court: Lower Fresh Bids Alone Cannot Justify Cancellation of an Auction  ||  Supreme Court Directs Delhi Police to Produce Section 163 BNSS Orders and Preserve CCTV Footage  ||  Supreme Court Affirms Menstrual Hygiene as a Fundamental Right, Warns States of Contempt  ||  Supreme Court Flags AI-Generated Fake Judgments Submitted in a Party’s Case Compilation  ||  Karnataka High Court: Vijay Mallya’s Flamboyant Lifestyle Hinders Settlement of Bank Claims  ||  Delhi High Court: Women can be Booked for Gang Rape without Physically Committing it  ||  Delhi High Court: Litigants Must Track Their Cases and Cannot Blame Lawyers for Their Own Inaction  ||  Allahabad High Court: Contract Workers Must Prove Work Parity With Regular Staff for Equal Pay  ||  Allahabad High Court Directs UP Trial Courts to Decide Maintenance Execution Cases Within Six Months    

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 2026 - All Rights Reserved