Page 13 - The Insurance Times July 2020

three years if the premium remains ment and terms and conditions of a tal and the hotel where the patient is
unchanged for the tenure. policy contract." put up," he said.
While pricing the policies on the basis In another case, a patient from Kolkata Rupak Barua, group CEO of AMRI Hos-
of age and health risk-factors, which said: "In my case, there is no mistake pitals and president of the Association
has been the practice, the premium on the part of the hospital. My wife of Hospitals of Eastern India, welcomed
cannot be changed for one year in the and I had Covid-like symptoms and we the IRDA move. "A large number of
case of renewable polices and three got the test done, which came posi- Covid patients do not need hospital ad-
years for the rest of the categories tive. When my wife's condition was mission. Many of them are opting for
(long-term). deteriorating, we admitted her to VP the satellite facilities where they are
Poddar Hospital." He further said: "The living in home-like conditions but under
To facilitate innovation, the regulator doctor advised that I should also get regular monitoring by a medical team.
has asked insurers to design pilot prod- admitted since my condition was seri- The bill paid at these facilities is part of
ucts that can be offered for a period ous too. We paid Rs. 50,000each. We the cost of treatment and we are happy
not extending five years after due ap- received a message from the insurance that the IRDA has recognised this and
proval. It can either be made a regu- firm that our claim was received. given its approval," he said.
lar product afterwards or withdrawn
on the basis of valid reasons. My wife was shifted to an ICU and was IRDAI permits modifica-
closely monitored. We both got dis-
charged on July 18." He said the insur- tion of group insurance
IRDAI mulls action on Hos- ance company, however, rejected both policies

pitals if they deny cashless their claims on the grounds that they IRDAI has permitted life insurers to
treatment could have been treated at home. modify the terms of 'Group Credit Life
IRDAI has warned network hospitals Covid patients in satellite Master Policies' of entities who have
against denying cashless treatment to availed moratorium on repayment of
Covid-19 patients.IRDAI said it had re- hospital facilities to get in- loans announced by the Reserve Bank
ceived several complaints in this re- surance cover in view of the COVID-19 pandemic.
gard. In one recent incident in Kolkata Covid patients who seek treatment at The life insurers, according to IRDAI,
Covid patient was asked to transfer to makeshift satellite hospital facilities, in- are allowed to "suitably modify the
another hospital if he was unable to cluding hotels, will now get insurance term and sum assured under the
deposit money in cash. Similarly in a cover, IRDAI has confirmed. All existing schemes, against the additional pre-
complaint filed with IRDAI, an IT pro- health policies will admit such insurance mium as may be required, so that they
fessional said that her mother infected claims. Earlier, only the newly introduced may continue to be covered as per the
with the virus was denied cashless Covid Kavach policy had this facility. revised loan repayment schedule."
treatment. "We acted on the com- This facility, however, will be available
plaint, spoke to the hospital authori- All leading private hospitals in kolkata, to only those entities which have opted
ties and ensured that the family including Apollo, AMRI, Bellevue, Wood- for moratorium in terms of RBI's an-
availed cashless treatment," IRDAI lands, Narayana Super Speciality, ILS, nouncement with regard to repayment
general manager (consumer affairs) TS Desun and Medica, have set up satellite of loans. "The modification shall be
Naik told TOI. facilities or tied up with hotels to func- limited to the extent required to en-
tions as satellite units to house mildly
In a statement, IRDA said: "We are sure that the coverage under the
aware of reports that some hospitals symptomatic Covid patients so as to free scheme matches the revised loan re-
are not granting cashless facility for up hospital beds for the more critical payment schedule," IRDAI said in a cir-
treatment of Covid19 despite having ones. About 75% of the over 200 hotel cular. The coverage for the extended
arrangements with insurers. We have rooms attached to these hospitals are period will have to be priced on the
also come to know that some of these already occupied, and the IRDA's latest same terms as the original cover, IRDAI
hospitals are demanding cash deposits circular comes as a huge relief to patients said. Life insurance companies had ap-
from policyholders. All hospitals that availing themselves of this service. proached the regulator to permit them
entered into agreements with insur- According to Sunil Parakh, CEO of Heri- to make certain modifications in Group
ance firms will have to provide cashless tage TPA, hotel rooms will be treated Credit Life Master Policies issued by
facility for any treatment, including as extensions of hospitals. "The billing them so as to align the cover available
Covid-19, to the policyholders in accor- has to be done by hospitals and there under such schemes with the revised
dance with provisions of the agree- should be an MoU between the hospi- loan repayment schedule. T

The Insurance Times, July 2020 13