Patients screened for COVID even in govt approved private hospitals will not be eligible for insurance claims

KATHMANDU, SEPTEMBER 4

The Insurance Board has issued a notice directing insurance companies to clear COVID-19 insurance claims of only those patients whose swabs are screened using polymerase chain reaction method at government laboratories.

Directing them to follow the criteria prepared by the government, the board has asked insurance firms not to clear claims if a PCR test report from a private hospital is submitted.

According to IB, the provision has already been mentioned in the COV- ID-19 Insurance Criteria-2020.

Sub-section 11 of Section 3 mentions the aforementioned provision. “This is not a new rule.

However, we have issued a notice in this regard just to avoid any violation of rules and make insurance firms alert,” said Raju Raman Poudel, executive director at IB.

The board has also issued the notice since there was some confusion among insurance companies while clearing claims for COVID-19 insurance schemes. As per the notice, PCR reports of patients from 47 laboratories across the country are eligible for COVID-19 insurance claim.

Patients screened for COVID in private hospitals, even if permitted by the government to conduct PCR tests, will not be eligible for insurance claims.

Meanwhile, Chunky Chhetri, general secretary at Nepal Insurance Association, said the rule was prepared by the government and not insurance companies.

Till date, more than 900,000 people have bought COV- ID-19 insurance, while more than 1,300 patients have made claims.

However, insurance companies have settled less than 300 claims.

A version of this article appears in e-paper on September 5, 2020, of The Himalayan Times.

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