Toughened Criteria for COVID-Related Health Insurance Claims

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Thailand’s insurance regulator, the Office of the Insurance Commission (OCI), has issued a new rule that limits health insurance claims from people infected with COVID-19. The rule goes into effect on February 15.

OIC Deputy Secretary General Apakorn Panlerd said the new rule is in line with Ministry of Public Health guidelines for the care of people infected with COVID-19, as revised on January 4, this which led to a modification of the conditions for the coverage of claims.

Under previous guidelines, all COVID-19 patients were considered hospitalized patients and entitled to claim medical expenses and compensation for lost earnings during the treatment period.

According to the new guidelines, however, a patient must meet one of five conditions in order to claim:

  • the patient has a fever above 39°C for more than 24 hours, or

  • the patient is an adult whose respiratory rate is greater than 25 times per minute, or

  • the oxygen content of the patient’s blood is less than 94%.

  • the patient has a chronic disease whose condition has changed or whose symptoms require close monitoring, or

Mr Apakorn says the new guidelines from the Ministry of Public Health cover insurance policies issued by life and non-life insurance companies regarding medical expenses and compensation, but do not cover insurance policies. COVID insurance who pay when the policyholder tests positive for the virus.

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