SC: Externally Procured Parts Given For Assembly, Not Used in Manufacture, Not Liable to Excise Duty  ||  SC: Upholding Surendra Koli’s Conviction on Rejected Evidence Would Violate Articles 14 and 21  ||  SC: In Execution Petition, Decree-Holder Must Prove Violation by Judgment Debtor  ||  SC: Insurers Must Compensate Accident Victims Despite Policy Breach, Can Recover From Owner  ||  Kerala HC: Long-Term Posting of Same Police Officer at Sabarimala May Affect Transparency, Efficiency  ||  Delhi HC: Post-Dated Cheques Given as Security Attract Section 138 NI Act After Liability Arises  ||  MP High Court: Railways Liable for Deaths on Tracks if it Fails to Take Preventive Measures  ||  Ker HC: NDPS Case Stands Even if Contraband Listed in Ml, if Chemical Report Shows Equivalent Weight  ||  Kerala HC: Father’s Retirement Benefits Can Be Attached for Child Maintenance Despite S.60(1)(g) CPC  ||  Supreme Court: A Decree Declared 'Nullity' Can be Challenged at Any Stage, Including Execution    

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