Page 48 - The Insurance Times June 2020

Circular

IRDAI Circular

Guidelines on Telemedicine rendering health services both through TPA and/or in-
house shall make the captioned TPA wise public
IRDAI/HLT/REG/CIR/149/06/2020 disclosures in the format specified at Annexure -1. The
Date:11-06-2020 data in the specified format shall be duly signed by
either CEO or one of the Whole Time Directors of the
1. Medical Council of India has issued ‘Tele Medicine Insurer.
practice guidelines’ on 25th of March 2020, enabling 2. The information shall be published within a period of
registered Medical Practitioners to provide Healthcare ninety days after the close of every financial year.
using Tele Medicine.
3. All TPAs shall provide the link of every insurance
2. In the above background, insurers are advised to allow company where the said information is available. The
telemedicine wherever consultation with a medical link shall be made available in respect of the insurers
practitioner is allowed in the terms and conditions of with whom the TPA had a service level agreement.
policy contract. 4. All TPAs shall also provide the requisite data or
3. Telemedicine offered shall be in compliance with the information to the Insurers, wherever called for, in order
Telemedicine Practice Guidelines dated 25th of March to enable insurers publish the above information in their
2020 and as amended from time to time. respective websites.
4. Provision of allowing telemedicine shall be part of claim 5. The policyholders desirous of knowing the details
settlement of policy of the insurers and need not be referred in annexure-1 shall be able to access all the
filed separately with the Authority for any modification. above information on visiting the website of respective
However, the norms of sub limits, monthly/ annual Insurer or the TPA.
limits etc. of the product shall apply without any 6. In case of termination of services of a TPA, the Insurer
relaxation. shall publish the same in its website along with the
5. This has the approval of the competent authority. reasons for termination within three days from the
effective date of termination.
(D V S Ramesh) 7. The above directions shall come into force with
General Manager (Health) immediate effect and data as at 31st March, 2020 shall
be published by 30th September, 2020.
Guidelines on Public Disclosures by 8. These guidelines are issued under the powers vested

Insurers on the qualitative and with Section 34(1) of the Insurance Act, 1938 read with
Regulation 3 (5) of Insurance Regulatory and
quantitative parameters of the health Development Authority of India (Third Party
services rendered to policyholders Administrators - Health Services) Regulations, 2016.
9. This is issued with the approval of Competent Authority.
IRDAI/HLT/MISC/CIR/146/06/2020
Date:10-06-2020 (DVS Ramesh)
General Manager (Health)
1. All general and health insurers registered with IRDAI

48 The Insurance Times, June 2020