Insurance for at-home treatments due to bed shortage? IRDAI to examine if patients are eligible for claims

New Delhi: On Thursday (May 27), the Delhi High Court has directed the Insurance Regulatory and Development Authority of India (IRDAI) to understand if people, who weren’t able to get hospitalisation due to lack of beds, can avail an insurance cover or not. 

Amid the second wave of coronavirus in the country, almost all hospitals in metro cities and tier 2 and 3 towns ran out of beds. At that many patients weren’t able to avail medical facilities, even if they were battling with some other disease than Covid-19. 

The High Court has now directed IRDA to update the court with a status report within four weeks. The division bench noted that the insurance policies in existence are not covering domiciliary claims unless the insured person is hospitalised. 

The HC noted that the majority of people would not be able to get any benefit under insurance policies as they could not get hospitalisation not because of their fault but due to lack of infrastructure. 

The court directed that any such consideration may take place by consultation between IRDA and insurance companies. The court said that there was an acute shortage of hospital beds not only in the national capital but all over the country due to the recent surge in COVID-19 infections and people were suffering as they were not able to secure beds and hence, many took treatment at home. 

The court also recorded the suggestion that the existing policyholders could be sent messages and given the option if they wish to get covered by the terms and conditions of the `Corona Kavach Policy` on payment of additional premium and that once the option is accepted, they should be covered under the same Corona Kavach Policy.

The bench was dealing with various issues arising out due to COVID-19 infections. Amicus Curiae Rajshekhar Rao suggested that IRDAI can verify claims of people who are not able to get beds and could not get a claim on insurance policy.