The Covid-19 claim amount is nearly 2.5 times of the average claims amount paid, said a top official of a standalone health insurer. He said the company is bracing up for increased claims for Covid-19.
"The Covid-19 claim amount is nearly 2.5 times that of the average health insurance claim," S. Prakash, Managing Director, Star Health and Allied Insurance Company Ltd told IANS.
He said Star Health has received a total of 201 claims (Covid-19 confirmed claims 44, Covid-19 suspected claims 157).
"The amount claimed will be about Rs 2.9 crore. The final pay out may vary -- it may go up or down," Prakash said.
According to him, the corporates have been renewing their group health insurance policies.
Meanwhile the Indian insurance sector regulator has directed non-life/health insurers to decide on the claims for treatment of
Covid-19 within two hours in the case of cashless mode.
In a circular issued the industry players the Insurance Regulatory and Development Authority of India (IRDAI) has directed the general insurers to communicate their decision for cashless treatment to hospitals within two hours from the time of receipt of authorisation request and last necessary requirement from the hospital either to the insurer or to the third party administrator (TPA)-the claims processing agency- whichever is earlier.
The IRDAI also said the decision on final discharge shall be communicated to the hospital within two hours from the time of receipt of final bill and last necessary requirement from the hospital either to the insurer or to the TPA whichever is earlier.
In the case of reimbursement claims - where a
policyholder pay the hospital upfront and claims the amount with the insurer- the claim will be settled only after the original papers are submitted to the insurer or the TPA.
"We have asked our policyholders to electronically send the claim papers for processing. Once the original papers are received the claim amount will be disbursed," Prakash said.
The insurers insist on original papers to prevent a policyholder who is having an insurance policy from a different company from making another claim.
