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FRIDAY, September 30, 2022
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OIC announces new rules for Covid-19 insurance payments

OIC announces new rules for Covid-19 insurance payments

THURSDAY, March 17, 2022
603

The Office of Insurance Commission (OIC) has come out with guidelines on insurance payment for treatment of Covid-19 policyholders under home isolation (HI), community isolation (CI) or hotel isolation.

The OIC announcement came after a meeting with the Thai Life Assurance Association, Thai General Insurance Association, and the Private Hospital Association (Thailand).

OIC secretary-general Suttipol Taweechaikarn said on Wednesday that they came up with two new guidelines:

1. For treatment of policyholders under HI, CI and hotel isolation, the insurance company concerned has to pay the actual treatment fees for outpatients up to the coverage limit.
For inpatients, the company must pay a treatment fee up to the coverage limit or up to a maximum 12,000 baht.

For policyholders with both outpatient and inpatient coverage, the insurance firm is required to pay the actual treatment fee up to the outpatient coverage limit.

If the fee exceeds the outpatient coverage limit, the insurance company must pay a treatment fee up to the inpatient coverage limit or up to a maximum 12,000 baht.

2. For daily/income compensation for policyholders under HI, CI and hotel isolation, the insurance company is required to pay daily/income compensation for each patient who needs a RT-PCR test and has one of the risk factors which require hospital treatment but could not get a room at the hospital.

The risk factors are:

  • People aged over 60
  • Chronic obstructive pulmonary disease
  • Other chronic lung diseases
  • Chronic kidney disease
  • Heart and artery diseases, and Congenital Heart Disease
  • Stroke
  • Uncontrolled diabetes
  • Obesity (weight over 90kg or with a BMI exceeding 30 kg/m2)
  • Liver cirrhosis
  • Weak immunity
  • Lymphocyte of fewer than 1,000 cells/μL.

The OIC will present these guidelines for enforcement under a registrar order and they will subsequently come into effect for two months. The OIC added that it would then monitor the situation periodically to adjust the guidelines.