Decoded: Active line of treatment in health policy

During the pandemic, there was confusion when some insurers rejected claims saying ‘no active line of treatment’ was followed at hospitals. What does it mean? A health insurance policy pays for hospitalisation expenses, but only if the patient is being actively treated and monitored by a doctor. For instance, it will not cover hospitalisation for diagnostic tests. Similarly, IRDAI-mandated Corona Kavach will pay home-treatment claims, but only if there is a “continuous, active line of treatment with monitoring of the health status by a medical practitioner...”. The Council for Insurance Ombudsmen has identified it as one of the clauses that need “proper interpretation.”