Covid Carnage: IRDAI urged to increase time limit for submission of insurance claim documents

Family members of the critically infected people are running pillar to post to secure beds, arrange oxygen cylinders, medicine etc.

The resurgence of Covid-19 pandemic has hit the nation like a tsunami that has thrown the grossly under prepared health system out of gear. Moreover, the highly infectious virus mostly infect almost all the members of a family staying in the same house.

As a result, family members of the critically infected people are running pillar to post to secure beds, arrange oxygen cylinders, medicine etc.

Due to prevailing uncertainty about securing a bed in a desired hospital, it’s not only difficult to complete formalities of the cashless hospitalisation process, but also the priority currently is admitting a patient first as soon as a bed becomes available and not waste any time in insurance related paper work.

With many family members down with Covid-19 and in some cases multiple deaths in the same family, it has become difficult for surviving members to perform even the last rites of the diseased persons at overloaded crematoriums/cemeteries, forget about collecting the required documents on time.

Moreover, many employees of insurance companies and insurance intermediaries – like insurance agents, development officers etc – themselves and/or their family members have also got affected by the pandemic, which makes it more difficult to carry on the claim process.

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Although, apart from the insured person and the nominee, any family member may intimate the insurance company about the happening of the insurable event, i.e. hospitalisation/death, but only the insured person/nominee may sign a claim form and claim the insurance money.

Also, it has become difficult for the scared and overworked TPAs (Third Party Administrators) and concerned hospital employees to issue documents related to pre-hospitalsation and hospitalisation expenses, death certificate etc on time.

“In case an insured person gets discharged from hospital, he/she may be asked to arrange the documents. However, in case of death of the policyholder, it’s difficult to press the relative(s) – who themselves may be suffering from the infection – for collecting documents quickly. Visiting a Covid infected family is also a matter of concern,” said Health Insurance Agent Sunil Grag.

“Apart from the delay in issuing the documents, disinfecting/sanitising the documents would take some time before handing over to the insurance company,” he added.

As a result, at this difficult time, insurance agents want the Insurance Regulatory and Development Authority of India (IRDAI) and the health insurance companies to allow at least 90 days time for submission of the required documents for processing of claims, rather than the standard practice of submitting within 7-15 days.