The OIC authorizes medical expenses-daily compensation outside the hospital, effective for 2 months.
Mr. Suthiphon Thaweechaikarn, Secretary-General of the Insurance Commission (OIC) revealed that according to the OIC held a meeting to discuss with the Thai Life Assurance Association. Thai General Insurance Association The Association of Private Hospitals continued. To jointly consider the approval of the payment of medical expenses and daily compensation to the insured who receive treatment under Home Isolation (HI) or Community Isolation (CI) or Hotel Isolation, according to the results of the meeting 4 The said parties reached a mutual settlement on 2 issues by allowing the payment to be compromised as follows:
Issue 1 Paying for medical expenses In the event that the insurance policy has only outpatient coverage shall be permitted to pay expenses as incurred but not exceeding the limit of outpatient coverage or in the case of an insurance policy There is only inpatient coverage. Grant consent to pay expenses as incurred. but not exceeding the limit of inpatient coverage and not exceeding 12,000 baht
In the case that the insurance policy has coverage for outpatients and inpatients Grant consent to pay expenses as incurred. but not exceeding the limit of outpatient coverage If there are expenses that exceed the outpatient coverage limit Grant consent to pay expenses as incurred. but not exceeding the limit of inpatient coverage and not exceeding 12,000 baht
Issue 2. Daily Compensation or Income Compensation will allow the payment of daily compensation or income compensation. Only in the case of the insured infected with the COVID-19 virus which has a test result by RT-PCR method and has one of the risk factors that must be admitted as an inpatient in a hospital However, there are no hospitals to support the following: Age over 60 years Chronic obstructive pulmonary disease (COPD) and other chronic lung disease Chronic kidney disease (CKD) Cardiovascular disease and congenital heart disease cerebrovascular disease Uncontrolled diabetes, obesity (weight greater than 90 kg or BMI of 30 kg/m3 or more), cirrhosis, immunosuppression, and lymphocyte less than 1,000 cells/m3.
In this regard, the Office of Insurance Commission will apply the aforementioned rules to issue the registrar’s order for further enforcement. This will be effective for a period of 2 months and will continue to monitor and review the said rules from time to time.
“The outcome of the meeting will reduce confusion and lay out clear guidelines. for the insurance company to follow This will help reduce disputes and alleviate the suffering of the insured who suffers from COVID-19 and undergoes HI CI or Hotel Isolation treatment in the same direction,” said Mr. Suthipol.
