Insurance policies

Health insurance policies will also cover Omicron treatment, clarifies IRDAI

Following the increasing number of reported cases of Covid-19 under the Omicron variant, the insurance regulator, the Insurance Regulatory and Development Authority of India (Irdai), has clarified that all health insurance policies issued by all General and health insurance companies that cover treatment costs for Covid-19 also cover treatment costs to the Omicron variant of Covid-19 under the terms and conditions of the policy contract, according to a press release issued on Tuesday 3 January 2022 by the regulator.

Previously, in another press release published on April 1, 2020, Irdai had indicated that all indemnity health insurance products that cover the cost of hospital treatment offered by general and health insurance cover the cost of treatment of hospitalization due to Covid-19.

“Irdai’s new guideline, released following infections caused by the new variant, is a move to provide policyholders with the full benefits of the health insurance scheme. The regulator has been instrumental during this pandemic where it introduced standard Covid-19 specific policies and included Covid treatment in all health insurance schemes. The new notification relates to similar customer service lines. As this is just a new variant of the same Covid-19, the guidelines stated previously remain the same. And health insurance companies are encouraged to follow the terms and conditions set out in their policies for any other treatment without imposing any particular condition,” says Naval Goel, CEO and founder of PolicyX.com, an insurance web aggregator.

The insurance regulator has requested all insurance companies to set up an effective coordination mechanism with all their network providers (hospitals) with the aim of providing a transparent cashless service to all policyholders in case hospitalization, if necessary, and to provide prompt services to all insured persons. .

Irdai has also asked hospitals to honor the service level agreements (SLAs) they have with insurance companies to provide cashless treatment to Medicare policyholders.

Irdai has provided this clarification to reassure policyholders and ensure they have no issues if they need treatment for an Omicron-related infection.