SUMMARY
IRDAI has asked insurers to include telemedicine under health insurance policy
Decision expected to help many insurance policyholders who had to visit doctors
Telemedicine is usually considered under out-of-the-pocket expenses
In a first, the Insurance Regulatory and Development Authority of India (IRDAI) has asked insurance companies to process insurance claims for telemedicine consultations while following the terms and conditions of medical insurance policies.
In a statement, IRDAI asked insurers to allow telemedicine as part of the claim settlement of their policies. This decision is expected to help many policyholders who had to go step out to visit a doctor in order to get their claims approved.
The move is also expected to promote the adoption of telemedicine across the country. At the same time, it will help doctors to diagnose patients remotely, thereby maintaining social distance. Meanwhile, this will also help many Covid-19 patients, who are having milder symptoms, to get proper treatment through telemedicine.
Currently, the ministry of health and family welfare’s website refer to telemedicne as “The delivery of health care services, where distance is a critical factor, by all health care professionals using information and communication technologies for the exchange of valid information for the diagnosis, treatment and prevention of disease and injuries, research and evaluation, and for the continuing education of health care providers, all in the interests of advancing the health of individuals and their communities.”
Head of insurance at Policybazaar.com Amit Chhabra told Economic Times that telemedicine is considered under out-of-the-pocket expenses. According to him, anyone taking telemedicine consultation from a doctor will be allowed to claim the expenses under a health insurance policy provided their policy covers OPD expenses.
He added that all policies which provide claims for OPD consultation expenses will now also cover telemedicine consultation service as part of the claim settlement of their policies.
Meanwhile, other insurance industry experts are suggesting that policy buyers should first check with their insurance companies if OPD covers are available in the policy or not.
According to IRDAI guidelines on telemedicine for all general and health insurers, telemedicine offered shall be in compliance with the telemedicine practice guidelines dated March 25, 2020.
IRDAI has also asked insurers to add the provision of allowing telemedicine as part of claim settlement of policy of the insurers and need not be filed separately with the authority for any modification.
In the wake of the Covid-19, the government has been keen on promoting telemedicine across the country. Recently, the government also launched the Aarogya Setu Mitr app that offers free telemedicine and consultation services for coronavirus-related inquiries. The app was launched in collaboration with Tata Bridgital Health, Swasth Foundation, Project StepOne and Tech Mahindra’s healthcare brand Connectsense Telehealth to offer teleconsultation services form verified doctors.
