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Less than 50% of COVID-related insurance claims settled so far: Report

Around 1.21 lakh claims worth Rs 4,538 crore are pending clearance and 1,337 claims have been so far rejected
Nov 9, 2020 / 12:20 PM IST

Insurance companies have settled less than 50 percent of the claims of nearly Rs 8,000 crore raised so far by COVID-19 patients.

Around 5.18 lakh insurance claims worth Rs 7,973 crore have been filed till November 3, of which 3.97 lakh or 77 percent have been settled. The amount settled, however, is only Rs 3,436 crore or 43 percent of the claim, the Hindu BusinessLine reported.

Around 1.21 lakh claims worth Rs 4,538 crore are pending clearance and 1,337 claims have been so far rejected, it added.

“Difference in claims made and those settled is due to the time lag between reporting of the claim and submission of final bills,” MN Sarma, Secretary General of the General Insurance Council told the paper.

He however added that insurance companies are “able to honour claims deemed reasonable and customary”, adding that hospitals were “exploiting patients by charging exorbitant rates.”

He said if insurance companies are to cover full bill amounts they would have to raise health cover premiums or exclude COVID-19 from policies.

COVID-19 Vaccine

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A vaccine works by mimicking a natural infection. A vaccine not only induces immune response to protect people from any future COVID-19 infection, but also helps quickly build herd immunity to put an end to the pandemic. Herd immunity occurs when a sufficient percentage of a population becomes immune to a disease, making the spread of disease from person to person unlikely. The good news is that SARS-CoV-2 virus has been fairly stable, which increases the viability of a vaccine.

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“There is a lack of standardisation in treatment cost and hospitals have either refused to treat patients with cashless policies or demanded upfront payment,” S Prakash, Managing Director at Star Health and Allied Insurance said, adding that discussions to solve this are on.

The issue was echoed by Sanjay Datta, Chief Underwriting, Claims & Reinsurance, ICICI Lombard General Insurance, who said “discussions to arrive at a common ground for referral rates” are ongoing and will resolve issues related to reimbursement and cashless treatment.
Moneycontrol News
first published: Nov 9, 2020 12:20 pm
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