Case Law Details
Vinay Jaidka Vs Chief Secretary (Delhi High Court)
Abhishek Nanda, ld. Counsel who appears for the Insurance Regulatory and Development Authority of India (hereinafter, “IRDAI”) was requested to appear before the Court. He submits that recently, the IRDAI has issued press releases dated 22nd April, 2021 and 23rd April, 2021 as per which it has been clarified that hospitals cannot charge differential rates to policyholders, demand advance deposits or deny cashless treatment to policyholders who have a cashless arrangement with the Insurers. Hospitals have also been requested not to differentiate between patients, in terms of admission or treatment, on the basis of whether they are insured or not and whether they pay cash or not. In the event of denial of a cashless facility at any network hospital, aggrieved policy holders may send a complaint to the Grievance Redressal Officer of the concerned insurance company.
Considering the above, the IRDAI is directed to issue immediate instructions to insurance companies/their agents to ensure that whenever requests are received for approval for discharge of patients who were affected by COVID-19 and are covered by insurance policies, no delay occurs in giving the approvals. Insurance companies/their agents be directed to communicate their approvals to the concerned hospitals/establishments within a maximum time period of 30 to 60 minutes, in order to ensure that the discharge of the patients is not delayed in any manner.
Moreover,once a patient is ready for discharge and while the attendant of the patient is waiting for the discharge slip to be processed, the hospitals /establishments can, instead of holding up the bed, process the new admission on that bed so that the bed does not remain unoccupied and needy patients are immediately given admission for their treatment.
FULL TEXT OF THE JUDGMENT/ORDER of DELHI HIGH COURT
Please become a Premium member. If you are already a Premium member, login here to access the full content.
Sir,
My enquiry is that if a patient is not admitted to hospital for Covid-19 bcz of unavailability of bed at hopsitals and home isolaltion is advised by physician under his treatment should insurance company entertain claim?? or can refuse?
iTS A NEW TOPIC – BUT RELATED TO COVID.
DOES HOME ISOLATION CAN BE TREATED AS HOSPITALISATION IN VIEW OF SHORTAGES OF BEDS AND ACCORDINGLY THE RECOMMENDATIONS BY THE MEDICAL AUTHORITY. IN SUCH CASE CAN WE CLAIM THE EXPENSES FROM THE INSURANCE COMPANY?