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Regular-article-logo Wednesday, 24 April 2024

Private hospital satellite units under regular insurance in Calcutta

Earlier, patients were being made to pay the entire amount from their pocket, which in many cases varied between Rs 3,000 and Rs 5,000 a day

Sanjay Mandal Calcutta Published 28.07.20, 01:00 AM
Following the IRDA guideline, the companies have started accepting claims under regular medical insurance policies as well.

Following the IRDA guideline, the companies have started accepting claims under regular medical insurance policies as well. Shutterstock

Satellite facilities set up by private hospitals to keep Covid-19 patients who have mild or no symptoms are now covered by regular health insurance schemes, insurance companies and hospitals said.

Initially, when the hospitals started creating satellite facilities by tying up with hotels, the insurance companies had refused to reimburse the expenses a patient incurred for staying there on the ground that the units were not part of the hospitals.

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So, patients had to pay the entire amount from their pocket, which in many cases varied between Rs 3,000 and Rs 5,000 a day.

But recently, the Insurance Regulatory and Development Authority of India (IRDA), the regulatory body for insurance companies, issued guidelines on handling claims reported under Covid-19, stating: “...it is important to recognise the makeshift or temporary hospitals permitted by government for settlement of health insurance claims”.

“When a policyholder who is diagnosed as Covid-19 positive is admitted into any such makeshift or temporary hospital on the advice of a medical practitioner or appropriate government authorities, notwithstanding the definition of hospital specified in the terms and conditions of policy contract, the treatment costs shall be settled by insurers,” the guidelines state.

“If the satellite facilities are created by hospitals in our network, then the claims will be reimbursed,” said Saurav Kariwala, assistant manager (medical), National Insurance Company Ltd, Calcutta.

An official of an insurance company said the entire amount of room rent charged by hospitals for staying in satellite facilities might not be reimbursed. “The permissible amount mentioned in the policy for daily bed charge can be reimbursed. However, the doctors’ consultations and medicines will be reimbursed like that in the hospital,” he said.

The insurance companies have also launched separate Covid policies. But now, following the IRDA guideline, the companies have started accepting claims under regular medical insurance policies as well.

Metro had earlier written about how these satellite centres were having few takers because the expenses were not covered by insurance.

“The IRDA’s decision to include satellite facilities of hospitals treating Covid-19 patients under the purview of insurance coverage is a welcome move,” said Rupak Barua, the group CEO of AMRI Hospitals and the president of the Association of Hospitals of Eastern India.

“We at AMRI Hospitals have come up with two satellite facilities and are looking at adding a few more because this is one option where we will be able extend support to positive patients who don’t need hospital admission but also don’t have the provision for self-isolation at home.”

The RN Tagore International Institute of Cardiac Sciences has tied up with two hotels with a capacity to keep 52 people. All rooms are full, said officials.

“Initially, the insurance companies had said they would not reimburse the cost. But now they have agreed and we have sent four to five claims for clearance in the last five days,” said R. Venkatesh, regional director, east, Narayana Health, which runs the RN Tagore hospital.

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