Large number of people can't get insurance benefit for want of hospitalisation, says HC  

The Delhi High Court Thursday said a large number of COVID-19 infected people would not be able to get insurance benefit as they could not secure a hospital bed due to the dearth of medical infrastructure and asked sectoral regulator IRDA to look into the issue. The court was also informed that effectively even black fungus infection will not be covered in COVID specific polices as they are only for 14 days period.

"As a matter of common knowledge and we can take judicial notice of the same that for about three to four weeks when the current wave of the pandemic was at its height, there was acute shortage of hospital beds not only in Delhi but in the entire country," a bench of Justices Vipin Sanghi and Jasmeet Singh said. The bench said people suffering from COVID-19 who required hospitalisation were not able to secure hospital beds, much less ICU or ICU with ventilators, and thus thousands of those who required hospital beds could not get them and had to take treatment at home with oxygen supply and other equipments NSE -0.14 %.

The court noted that the insurance policies issued by various companies which have been in existence do not cover claims unless the insured is hospitalised and it appeared it is only 'corona kavach' policy which covers home treatment. "Therefore, large number of insured people would not be able to receive any benefit under the policy held by them only because they could not get a hospital bed of no fault of their and due to dearth of medical infrastructure," the bench said.

It asked the Insurance Regulatory and Development Authority (IRDA) to discuss with insurance companies the terms and conditions under which they can be covered.

During the hearing, one of the advocates suggested that existing policy holders of medical health insurance be sent messages and given an option if they want to be covered under the corona kavach policy by paying additional premium and once it is accepted they can be covered under it and this would extend the reach to a large number of people. "We are of the views that these are valid point placed before the court and we direct IRDA to examine these aspects and place further status report," the bench said while listing the issue for further consideration on July 14.

On being informed that COVID specified polices are for people of 18 to 65 age group, the bench said that as per data, people above the age of 60 years are more prone to coronavirus issues and excluding them will not help in the purpose of overcoming COVID-19 issues. The bench asked IRDA to consider coming up with a COVID specified insurance policy for citizens above the age of 65 years. The court noted that IRDA has taken steps to mitigate the sufferings of people on account of COVID-19, however, there are a couple of issues that it should consider.

The bench was informed by advocate Abhishek Nanda, appearing for IRDA, that in the wake of the pandemic, it has notified two policies, that is, Corona Kavach Policy and Corona Rakshak Policy and apart from them, various companies are offering other policies on individual and group basis.

While corona kavach policy covers cost of COVID-19 treatment on hospitalisation and home care, corona rakshak policy's pays a fixed amount on showing COVID-19 positive status.

The IRDA counsel said till April 30, 26.37 lakh corona kavatch policies were issued and 4.73 lakh corona rakshak policies were issued and added that they were available at reasonable premiums. On this, the bench said, "if you were to compare the premium collected with the amount disbursed, the premium would be much more and insurance companies are not doing any charity."

Source: The Economic Times

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