A wrong decision by the insurance regulator bites the dust. The requirement of a hospital to have minimum 15 beds for it to be covered under mediclaim has been scrapped. The benefit to include smaller nursing homes far exceeds the risks of any mediclaim fraud
Insurance Regulatory and Development Authority’s (IRDA) guidelines on standardization in health insurance defined hospital with at least 10 in-patient beds, in
those towns having a population of less than 10 lakh and with 15 in-patient beds at other places. It was becoming a big issue for small nursing homes as mediclaim policyholders would not been covered there. Nursing home owners had termed the move as ‘unreasonable’. In Mumbai, 684 out of 1,200 nursing homes have less than 15 beds. The Association of Medical Consultants (AMC), a body of over 7,500 doctors in the city, had also filed a petition challenging IRDA’s circular on bed restriction for mediclaim cover.
On 5th July, IRDA told the Bombay High Court that it has withdrawn the bed restriction clause. The hospitals will need to be registered with the local authorities under the Clinical Establishments (Registration and Regulation) Act, 2010,...