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Health Insurance: Telemedicine, online consultation to be covered amid COVID-19 How it works?

  • In the wake of the coronavirus pandemic, people prefer to consult with doctors online rather than go for regular check-ups at hospitals.
  • IRDAI asked the insurance company to allow claims for a telemedicine consultation to be settled under a health insurance policy.

Starting in October, the telemedicine consultation will be covered by health insurance policies. The Insurance Regulatory and Development Authority of India (IRDAI) has requested the insurance company to allow claims settlement for a telemedicine consultation where normal consultation with a doctor is allowed on the terms and conditions of the contract of the policy.

In the wake of the coronavirus pandemic, people prefer to consult with doctors online rather than go for regular check-ups at hospitals. Many hospitals have started providing nursing services in patients' homes to keep them in the midst of the pandemic. This last step by the insurance regulator will be beneficial to these policyholders.

"Telemedicine is becoming more prominent today. Health policies that cover counseling through physical visits should also include telemedicine consulting," said Krishnan Ramachandran, MD and CEO of Max Bubba Health Insurance.

Commenting on the inclusion of telemedicine in health insurance policies, Shanai Ghosh, CEO and CEO of Edelweiss General Insurance, said: "Telemedicine provides significant convenience to clients by reducing the cost and time associated with travel and avoid the risks of contagious infections like COVID-19 ".

What is telemedicine?

“To provide health services, where distance is a critical factor, by all health professionals who use information and communication technologies to exchange correct information for the diagnosis, treatment and prevention of diseases and injuries, research and evaluation, and continuous education of health workers with the objective of promoting health. Individuals and communities ”, according to the guidelines issued by the Ministry of Health and Family Welfare. The guidelines stated that a registered physician has the right to provide telemedicine advice to patients from any part of India.

How does it work:

Anyone who receives a remote medical consultation from a doctor will be able to claim the expenses of the medical insurance policy, if their medical policy covers the expenses of OPD. If telemedicine consultations are part of the pre or post hospital expenses, clients can receive the costs covered by the medical insurance policy.

Insurers are advised to allow telemedicine as long as consultation with a doctor on the terms and conditions of the policy contract is allowed, as per the telemedicine practice guidelines of the Medical Council of India, Medical Council of India, as per the IRDAI. Providing telemedicine permits should be part of the insurance companies' claims settlement policy and does not need to be filed separately with the authority for any modifications, as stated. However, the standards for sub-limits, monthly or annual limits, etc. of the product should be applied without any dilution.