Corona Kavach policy: Regulator Irdai on Tuesday asked insurers to give 5 per cent discount on ‘Corona Kavach’ premium to doctors and health workers, and ensure that hospitals do not deny cashless treatment to insured persons in conformity with the terms of policy.
As mandated by Irdai, all the 30 general and health insurers that offer indemnity based health insurance have started offering individual COVID-specific Standard Health Policy called “Corona Kavach”.
“As a gesture of acknowledgment of the contribution of healthcare sector in the nation’s fight with COVID-19, the insurance companies will provide a 5 per cent discount in premium of ‘Corona Kavach’ to doctors, nurses and other healthcare workers…,” Irdai said in a release.
Corona Kavach policies are for three and half months; six and half months; and nine and half months with sum insured ranging from Rs 50,000 to Rs 5 lakhs (in multiples of Rs 50,000).
In another statement, Irdai said it is aware of reports that some hospitals are not granting cashless facility for treatment of COVID-19 despite such arrangements with the insurers.
The regulator further said it has also been brought to the notice of the authority that some of these hospitals are also demanding cash deposits from the policyholders.
Therefore, it is clarified that the policyholders are entitled to cashless facility at all network providers (hospitals) with whom the insurance company/TPA has entered into an agreement in accordance to the norms of service level agreements (SLA), it said.
“Insurance companies have been directed to ensure smooth availability of cashless facility with all the network providers (hospitals) empanelled with them by actively interacting with the hospitals,” it added.
In the event of denial of cashless facility at any such enlisted network providers (hospitals) the aggrieved policyholders can send a complaint to the concerned insurance company.
As per the provisions, general and health insurance companies are expected to enter into agreements with public and private sector healthcare providers across the geographical spread.
The list of the network providers with whom the insurance company has entered into a service level agreement has to be published on the websites of the insurers and TPAs (Third Party Administrators).
Insurance Regulatory and Development Authority of India (Irdai) said where SLAs are entered with hospitals, it is essential for all such hospitals to provide cashless facility for any treatment to the policyholders, including COVID-19 treatment.