IRDAI allows home treatment under health insurance policies as add-on cover

Given the increasing number of home treatment cases for Covid-19, the Insurance Regulatory and Development Authority (IRDAI) has allowed non-life insurers to offer homecare treatment as an add-on cover. The cover can be bought with new as well existing policies. Insurers can charge an additional premium for extending the coverage in tune with the remaining period of the coverage. IRDAI has defined homecare treatment as one taken at home for an ailment that normally needs hospitalisation provided that a medical practitioner advises the insured home treatment; there is a continuous active line of treatment with the health status of the insured monitored daily by a medical practitioner during the duration of home treatment; and that records of daily monitoring of the insured patient and the treatment given are recorded and signed by a medical practitioner. Norms for settlement of claims should be mentioned in the policy document and prospectus, it said.

Under domiciliary hospitalisation, medical expenses are covered by your health insurer provided it is an in-built cover in your policy or if you have opted for it as an add-on cover. Domiciliary hospitalisation, however, does not include any type of treatment that lasts less than 72 hours.

Industry view

Reacting to the development, Liberty General Insurance Ltd’s CEO and Whole Time Director Roopam Asthana told IANS that the “add-on cover has to be priced right taking into account the data and possible scenarios”.

Experts say now when the second wave has subsided the add-on the cover may not be so useful, but it keeps us prepared if there is a third wave as no one know how it might pan out.

Fine print

Separately, one of the fine prints under domiciliary treatment for Covid-19 cases is many policies do not cover ‘Upper Respiratory Tract Infection’. At the time of taking the add-on cover, one should make it clear with the insurer about the coverage of Covid-19 cases.