In the hospital just for isolation? Insurance claim can be rejected | Nagpur News

Nagpur: A positive Covid report in the city is now leading to mandatory institutional quarantine, either in a free government facility or by paying a private hospital facility. In the latter case, financial advisors and hospital administration sources say claims for reimbursement of bills may be denied by insurance companies. This is because mild or asymptomatic cases do not require hospitalization from a medical point of view. This gives the insurers the option to refuse the claim.
Even if facilities in quarantine centers such as the MLA Hostel or state hospitals are free, beds in private facilities are chargeable. The majority of patients in the current wave are only getting acetaminophen for a fever, along with vitamin tablets. A number of other patients who are completely asymptomatic are only kept under observation. However, since they are Covid-positive, they end up in a hospital or quarantine center.
“The minimum charge for an oxygenated bed is 4,000 rupees regardless of whether the symptoms are mild. The patients have to stay seven days, “said Dr. Anup Marar, chairman of the Vidarbha Hospitals Association.
The health insurances pay the hospital stay cashless or only reimburse if the admission is justified. These complaints will be processed on your part after a detailed examination.
“If parameters are normal or patients can be treated at home, the application can be denied on the grounds that no hospitalization was required,” said Manoj Aya of GNTL Financials, an insurance consultancy. The most important parameters include oxygen content and temperature.
Prasanna Dani, also an insurance advisor, confirmed that such claims, if filed, are likely to be denied.
“The majority of patients these days do not require major medical treatment and the cases can be treated at home,” said Dr. Nitin Shinde, Infectious Disease Specialist at Alexis Hospital.
Aside from concerns about bed occupancy, the unavailability of insurance will also be an issue, a hospital source said.
A private hospital in the city has already stopped admitting Covid patients if they have no or mild symptoms. They are only being told to find another hospital, a source said.
“The patients get mild symptoms, which are treated with paracetamol or cough medication if necessary. Sometimes the fever barely lasts a day, ”said Dr. Rajan Barokar of Kingsway Hospital. Fear of forced isolation has also kept the number of tests low, he said.
Policies like Corona Rakshak were introduced during the first wave of Covid. Below that, even a positive test received coverage of Rs2.5 lakh. This system made insurance companies pay huge sums of money and was not promoted in the second wave. Even insurance agents aren’t pushing the programs because of their low premiums, a source said.


Comments are closed.