Dear Sir

It is our honest endeavour to provide you with the best of the services and in this direction , we would like to highlight  the recent guidelines of the GIC Council to stream line the processing of mediclaims related to the COVID-19 treatment.

•  In order to allay the fears of all insurance policyholders and to bring complete clarity and transparency in the treatment of Covid-19 insurance claims, the General Insurance Council has brought about a Schedule of rates for Covid-19 claims being filed with its member insurance companies. Insurance companies shall be guided by the Treatment Protocols prescribed by ICMR. These rates are broadly based on the schedule of rates suggested for covid-19 treatment by NitiAyog Panel.
• These charges shall be reviewed by Council every month  .
• The settlement under the Covid-19 insurance claims shall be subject to the limits and terms of the policy of respective insurer.
• This document hence proposes to create a consensus on the billing pattern for COVID patients, on a Per Diem Bases, rather than line item billing, based on the following criteria –
• a. Type of stay & treatment, during hospitalization  b. City/District of Hospital  c. Type of Hospital
• Depending upon the category of hospitals and level of the sickness the cost per day as a ceiling has been decided. ( please refer point no.1 of the attachment)
• Then again depending upon the type of the city and hospitals theses ceilings will be adjusted further. ( please refer point no.2 and 3 and 4)
• They have highlighted what are the expenses under different heads are included under the per day ceiling
•  And also what are the expenses under different heads are to be considered separately outside the ceiling .
• GIC council has clarified the limit for the PPE, and the treatment of any co-morbid conditions.

Some of the hospitals may charge on a higher side, but the  insurance companies will process the claims as per the guidelines of the GIC Council. So to avoid such situations, proper care has to be taken at the time of the admission and before finalisation of the bills.

In case further help or clarification is required, kindly contact us. Beacon is always happy to help.