In the hospital only for isolation? Insurance claim can be refused | Nagpur News

Nagpur: A positive report on Covid in the city now leads to compulsory institutional quarantine, either in a free public establishment or by paying for a private hospital establishment. In the latter case, financial advisers and hospital administration sources say there is a chance that bill reimbursement claims will be rejected by insurance companies. Indeed, mild or asymptomatic cases do not require hospitalization from a medical point of view. This gives insurers a chance to dismiss the claim.
Although facilities in quarantine centers like the MLA Hostel or public hospitals are free, beds are chargeable in private facilities. The majority of patients in the current wave only receive paracetamol, in case of fever, as well as vitamin tablets. A number of other patients, who are entirely asymptomatic, are only kept for observation. However, since they are positive for Covid, they end up in a hospital or a quarantine center.
“The minimum price for an oxygen bed is 4,000 rupees, no matter how mild the symptoms are. Patients have to stay for seven days, ”said Dr Anup Marar, president of the Vidarbha Hospitals Association.
Insurance companies will only cover hospitalization, either in cash or with reimbursement, if admission is justified. These complaints are processed after a thorough check on their part.
“If the parameters are normal or if the patients can be managed at home, the request can be rejected on the grounds that hospitalization was not necessary,” said Manoj Aya of GNTL Financials, an insurance consultancy firm. . Key parameters include oxygen level and temperature.
Prasanna Dani, also an insurance advisor, also confirmed that such claims, if submitted, would be subject to dismissal.
“The majority of patients these days do not need major medical treatment and cases can be managed at home,” said Dr Nitin Shinde, infectious disease specialist at Alexis Hospital.
Along with concerns about bed occupancy, the unavailability of insurance is also becoming an issue, a hospital source said.
A private hospital in the city has already stopped taking Covid patients if they have no symptoms or are showing mild symptoms. They are simply being asked to look for another hospital, a source said.
“Patients have mild symptoms, which are treated with paracetamol or cough medicine if necessary. Sometimes the fever lasts as little as a day, ”said Dr Rajan Barokar of Kingsway Hospital. Fears of compulsory isolation also kept the number of tests low, he said.
During the first wave of Covid, policies like Corona Rakshak were initiated. By virtue of this, even the positive tests got coverage of Rs2.5 lakh. This scheme let insurance companies pay huge sums and it was not encouraged in the second wave. Even insurance agents aren’t pushing the programs because of the low premiums, a source said.


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