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

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.

“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.

Original Source: https://www.moneycontrol.com/news/business/less-than-50-of-covid-related-insurance-claims-settled-so-far-report-6089891.html