Ø  Is buffer eligible for COVID.

As per Insurers discretion

Ø  Whether Covid19 treatment will be covered in GHI?

Covered

Ø  When a patient gets admitted for any ailment, is COVID test compulsory. In that case what is the test charges and whether that is admissible.

Covid test done before a surgery is payable

Ø  Is there any copay on this treatment,

Existing policy terms and conditions apply

Ø Since mostly the treatment require ICU which might have higher costing than its limit defined in the policy coverages, will there be any relaxation for COVID19 patients.

Isolation wards will be adjudicated as per eligible room category

Ø Is there any capping on COVID 19 Treatment Expenses.

No caps in specific. Existing policy terms and conditions apply

Ø Any package available for the treatment of COVID 19

No package available

Ø Does room rent charges applies for COVID admission & Whether proportionate clause applied for room rent of COVID19 claims

Room rent and proportionate clause applicable

Ø Is the testing of COVID is also covered under the policy

Standalone tests not covered

Ø How about preauth flow in this lock down period.

We are receiving emergency hospitalizations

Ø What are the hospitals in network providing COVID 19 Treatment.

The network team doesn’t have a separate list as of now- they consider the Govt approved hospitals to allow treatment for COVID. Incase of pvt Hospitals - they require a document stating that they have permission from governing authorities to carry out COVID treatment

Ø Due to lockdown many employees are enquiring if there is any relaxation on claim submission/intimations.

No, IRDA or Insurer has not issued any circular regarding this

Ø Many employees are asking if claim settlement will be possible basis the soft copy of the claim documents.

Yes, We have allowed many shortfalls and mandatory documents to be allowed to be submitted as soft copy at this time. However under the conditions that they provide a letter of declaration mentioning the following :
a. all documents are soft copies of the originals.
b. No other copies have been to presented to any other Insurer or TPA.
c. once lockdown is lifted, the original copies are submitted to respective branches.
Exception - HCL Claims- Requires Ordinance

Ø How is Vidal managing with their day to day activities in this lock down period.

All employee have been allotted work and asked to send reports pertaining to the same. Along with the usual work, additional tasks add on tasks have also been assigned. Daily meetings and discussion with the help of zoom call, whatsapp groups and calls within team members.

Ø Is COVID treatment /test is admissible in all hospitals/labs

No, COVID treatment / test is admissible only in COVID-19 designated hospitals and COVID-19 designated labs

Ø Do we have any specific list of the same.

Yes, I have shared the list as per 25/04/2020

Ø Is there any Covid +ve found in your nearby place if so what distance and measure taken by you

SOG Team

Ø If a pregnant mother found to have this Virus does that affect the child. And if a mother delivers will the child have this virus by default.

As per ICMR till now we don’t have sufficient data for this, Hence it is considered as No. Transmission of coronavirus during pregnancy is unlikely, but after birth a new-born is susceptible to person to person spread as per CDC & WHO

Ø Can a common man do COVID Testing in any local lab

No, Tests needs to be done only in COVID-19 designated labs listed by ICMR- Also there is a pre-requisite of list of symptoms which must be reported for testing to be carried out at designated labs.

Ø Is any testimonials / awareness messages available in Vidal website /Whatsup / Mobile app etc for COVID.

yes, In website available in the name of Corona Care 24/7 multi lingual help desk that connects you with health care professionals

Ø How are reimbursement claims getting processed in VIDAL.

The claimant can send soft copies of the claim either by - mail, on portal or whatsapp. This is collected by inward team and added to DMS from where the processing team goes ahead and does normal processing of claims

Ø What is the TAT and whether claims are moving to payment in case all documents are in order.

OPS Team.

Ø After lock down how will VIDAL manage the inflow of claims.

OPS Team.

Ø  How are providers managing with non settlement of their network claims.

As a part of the BCP plan- we have allowed claimant to submit claims via any of the 3 methods (during lockdown period)- a. via web portal, b. via email, or c. via whatsapp message.
As per guidance from Insurer- Payment of claims can be done with soft copy of claims provided the claimiant provides a letter of declaration along with the claim documents stating that these are all original documents , No copy of the same is provided to any other insurer/TPA, and that they will be submitting the original copies to respective offices with 15 days/3months(depending on insurer) of end of lockdown period.

Ø  Will they deny any genuine emergency cashless due to this.

NO,Cases will be denied only if it doesn’t meet policy T&C

Ø  Will all smokers have chance of getting this COVID.

As per WHO Smokers are likely to be more vulnerable to COVID-19 as the act of smoking means that fingers are in contact with lips which increases the possibility of transmission of virus from hand to mouth. Smokers may also have lung disease or reduced lung capacity which would greatly invrease the serious illness

Ø  VIDAL being in health industry, did any analysis done to find out increase in no. of COVID victims and what is the impact going to be in next few months.

Ø  As per Health Ministry what is the fate of our State.

As per COVID task force on 26/04/2020 the rate of doubling is 10 days once in India, this data shows the cuve is flattening. Kindly find the attachment for the same

Ø  What do I do if my health insurance is a self-funded plan?

You can submit the claim like all other claim- No variation for submission of COVID-19 claims

Ø  Will my health insurer waive my deductible/ co-payment since this has been declared as emergency.

No, cases will be processed as per policy T&C

Ø  Can my insurer cancel or refuse to renew my policy if I get COVID-19

No

Ø  I have health insurance through my employer. What happens if I lose my job

If you incur a Covid-19 claim after your termination - you will have to bear the expenses from your own pocket- as per policy terms and conditions.

Ø  Are appended test covered under GMC and is it covered if the member is not hospitalized

o   swab test: The lab will take a special cotton swab and sample the inside of the throat or nose

Covered as per policy T&C, in case OPD is covered tests will be covered without hospitalisation, otherwise it will be covered only if the member is hospitalised and as per policy T&C

o   nasal aspirate: The lab will inject a saline solution into your nose, then remove the sample with gentle suction.

Covered as per policy T&C, in case OPD is covered tests will be covered without hospitalisation, otherwise it will be covered only if the member is hospitalised and as per policy T&C

o   tracheal aspirate: A thin, lighted tube called a bronchoscope goes into your lungs, where a sample will be collected

Covered as per policy T&C, in case OPD is covered tests will be covered without hospitalisation, otherwise it will be covered only if the member is hospitalised and as per policy T&C

o   sputum test: Sputum is a variation of mucus from your lungs that can be coughed out or sampled from the nose with a swab

Covered as per policy T&C, in case OPD is covered tests will be covered without hospitalisation, otherwise it will be covered only if the member is hospitalised and as per policy T&C

o   Blood test.

Covered as per policy T&C, in case OPD is covered tests will be covered without hospitalisation, otherwise it will be covered only if the member is hospitalised and as per policy T&C

Ø  Does screening of staff members covered

Existing policy terms and conditions apply

Ø  Vidal will arrange for any Covid-19 test arrangement for corporates once the lock down is completed or vidal have any tie up with any lab for vidal customers at discounted price.

Vidal can help you find the concerened lab for testing and network hospitals incase for hospitalization in your preffered location. However as of now we donot have any tie ups with testing labs and are not conducting any such tests themselves.

Ø  Need to know the documents submission process

The claimant can send soft copies of the claim either by - mail, on portal or whatsapp.

Ø  Mandatory documents for covid if any on claim submission

All COVID-19 lab reports confirming the diagnosis, other investigation reports which have done, admission notes, detail line of treatment/ drug chart, IPD papers, Temperature chart, if there is extended stay the justification letter by treating doctor

Ø  How corporates to handle this COVID once lockdown is completed. Vidal has any PPT for the same to circulate  or posters etc.

If any such requirement comes from corporate- Vidal can publish articles / posters present and also in the monthly / weekly newsletter.