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IRDAI asks insurers to Include Telemedicine as Part of Claim Settlement of Policy

Health insurance plans

Did you know India is the second largest online market in the world with more than 560 million users?

Internet penetration has increased considerably in the past decade and today individuals living even in the remotest part of the country have access to the internet and/or Smartphones. This has allowed individuals to access online services easily without any hassles. So, if you want to buy that trendy mobile phone or groceries, everything is available online. Even in the case of healthcare, consultations through phones and video calls as well as online consultations are steadily becoming popular. Why visit the doctor when the doctor can come to you through your computer or Smartphone? This type of medical assistance is called telemedicine which eliminates the need to physically visit a doctor for medical check-ups.

Before the Coronavirus pandemic became a cause of concern, telemedicine was in its development stage in India with few people actually making use of it. However, with the Government imposed lockdown and the threat of contagion, telemedicine is becoming popular. Understanding the feasibility and benefits of telemedicine, the Insurance Regulatory and Development Authority of India (IRDAI) has advised health and general insurance companies to allow coverage for telemedicine in their policies. Thus, plans covering medical costs, viz. health insurance plans, would now pay claims for costs incurred on treatments and consultations through telemedicine.

Introduction of the telemedicine guideline

The concept of telemedicine is relatively new and so if you have not heard about it, it’s understandable. On 25th March 2020, the Medical Council of India (MCI) issued Telemedicine Practice Guidelines which allowed registered medical practitioners to offer healthcare services through telemedicine. This was done to prevent spreading of Coronavirus through contact. The council reasoned that as healthcare workers and their patients avoid physical contact through the availability of telemedicine, the spread of the virus would be contained. The Board of Governors appointed by the MCI stated different types of technologies available under telemedicine which would allow patients to get medical attention without physical contact. This can prevent the spread of the virus keeping both doctors and patients safe from the illness.

IRDAI’s regulation on telemedicine

Taking the telemedicine guideline forward, the IRDAI directed health and general insurance companies to cover telemedicine as a part of their claim settlement. Given this pandemic, this is a welcome move by the regulator. 

Here’s what IRDAI guidelines stated –

  • Telemedicine would be a part of the insurance claim in health insurance policies if medical consultations are covered under the plan
  • A separate claim is not required to be filed for claiming the cost of telemedicine
  • Any limits or sub-limits applicable to the coverage benefits would continue to apply without any changes

Impact of the regulation

The inclusion of telemedicine in claim settlement is a beneficial move for policyholders. You can now avail telemedicine facilities for your medical issues and get covered under your health insurance plan for the costs incurred. This would help keep you safe from contracting the virus as you can avoid visiting doctors and medical practitioners for consultations.

The pandemic has brought about many changes in people’s lifestyles and you have to adapt to these changes as the disease would take some time to get under control. This measure by the IRDAI is a relief for policyholders as it gives them the freedom to get medical attention without the risk of contagion.

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