SC: Recoveries U/S 27 of Evidence Act Alone Cannot Sustain Conviction; 1988 Murder Acquittal Restored  ||  SC: Successive Impleadment Applications are Barred by Res Judicata under Different CPC Provisions  ||  Supreme Court Halts Coercive Measures in CJP Protest Cases, Directs Release of Minors  ||  Supreme Court: National Commission for Scheduled Castes Lacks Power to Pass Binding Orders  ||  Bombay HC: Alleged Illegal Arrest Alone Cannot Trigger Contempt Action Against Police  ||  Bombay HC Quashes Order against Taiwan National, Says Online Study Didn't Breach Visa Rules  ||  P&H High Court Issues Directions on LADC Scheme After Reviewing Lawyers' Objections  ||  Allahabad HC: Suspension of Sentence Plea Need Not Take Priority if Appeal is Ready  ||  Allahabad High Court: Surcharge Recovery From Pradhan Must Follow Panchayat Raj Act Procedure  ||  Allahabad HC Directs IB Probe into 4 Lucknow Lawyers, Raises Concern over Lawyer-Police Nexus    

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