SC: Completed Trial can't be Remanded for Procedural Lapse Unless Prejudice is Proven  ||  SC: Sessions Courts Cannot Bar Statutory Remission and Commutation Through Special Sentences  ||  SC: Article 311 Bar Inapplicable If Removing Officer Equals Appointing Authority in Status  ||  SC: Contractual Bar Prevents Arbitral Tribunal From Awarding Pre-Reference Interest  ||  SC Frames Guidelines to Prevent POCSO Act Misuse by Parents in Custody Disputes  ||  Delhi HC Directs DLSA to Convey Trial Court’s Encouraging Message and Compensation to POCSO Survivor  ||  Delhi HC: Gravity of UAPA Offence Cannot Justify Prolonged PMLA Detention  ||  Delhi HC Affirms Equestrian Federation's Youth Olympics Selection, Calls for Clearer Norms & Timeline  ||  Delhi HC: Ajeet Bharti Used Caste Superiority to Humiliate Chandrashekhar Azad  ||  Supreme Court: Anti-Suit Injunction Cannot Rest on Speculation of Unenforceable Foreign Decree    

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