According to Indian insurance industry, the recent move by the Insurance Regulatory and Development Authority of India (IRDAI) to include home care for COVID-19 patients with mild symptoms in the standard COVID-19 health insurance cover could turn out to be a game changer for the Indian health insurance.
Following the new guidelines by the IRDAI, an increasing number of insurance companies are now looking to provide cover to COVID-19 patients being treated at home. This is largely because COVID-19 patients with mild symptoms are being encouraged to stay home so that they don’t strain the already stretched infrastructure at hospitals.

Most of the existing health insurance policies require that patients be admitted to a hospital for at least 24 hours before they can benefit from the policy.

SureClaim co-founder and CEO Anuj Jindal speaking with Asia Insurance Review said, “COVID-19 is a special use-case both in healthcare and health insurance. Given that IRDAI has recommended a specialised indemnity product for COVID-19, this explains the unprecedented situation we are dealing with.”

He said, “Covering home healthcare for COVID-19 is a welcome step that will make insurance more customer-centric as well as reduce healthcare costs.”

ICICI Lombard General Insurance chief (underwriting, claims and reinsurance) Sanjay Datta said ICICI Lombard has recently rolled out home healthcare benefits, allowing customers to get treated at their residence for any ailments.

He expects the insurance sector to start covering home healthcare, but it will take some time before specialised standalone home health covers are launched in India.

Mr Jindal said, “When it comes to extending home healthcare for other diseases, some insurers have been offering this facility on a cashless basis for several years now in their corporate health policies. It is need of the hour to make home healthcare coverage ubiquitous in India.”

Under the IRDAI guidelines for homecare for COVID-19 the insurer will cover the costs of treatment of COVID-19 incurred by the insured person undergoing treatment at home up to a maximum of 14 days, provided the person is advised to get treatment at home by doctors.

Other conditions include constant monitoring of the patient’s health status by doctors every day; daily monitoring chart including records of treatment. Both cashless and reimbursement facility are offered under homecare expenses.

In case the insured person intends to use the services of a non-network provider, the claim shall be subject to reimbursement, prior approval from the insurer needs to be taken beforehand, the guidelines suggest.

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