The Role of Telemedicine in Faster Claim Settlements

What is Telemedicine?

As the name suggests, telemedicine is simply healthcare that is provided over telecommunication. It is an alternative to physical consultation with a medical practitioner that allows patients to seek medical advice, get a diagnosis, etc, through digital methods known as telecommunication. Access to medical practitioners over chats, calls, video calls, etc, is gaining popularity.

Telemedicine has been a part of the healthcare world for many years, but post-COVID-19, it gained wide popularity as a reliable method for patients looking for general consultations, diagnosis, and treatment options. While there might be certain constraints of telemedicine in emergency cases or critical illnesses, it has surely bridged the gap between insured and insurers in cases of claim settlement.

Did You Know that in the wake of COVID-19, the Insurance Regulatory and Development Authority of India directed insurance companies to include telemedicine as a part of the health insurance claim settlement process for faster settlements?

Faster Claim Settlements: How Does Telemedicine Help

Telemedicine has several advantages for patients seeking medical advice. Let’s now evaluate its role in facilitating faster claim settlements:

Access to Medical Records

Insurance companies often take longer to evaluate the medical records of individuals. Verifying medical records that are either too old or illegible becomes a hurdle and delays the process of claim settlement. Inclusion of telemedicine allows digitalisation of medical records that are easily and quickly verified.

Quick Digital Prescriptions

In many cases, traditional prescriptions reach the insurer late, and even after insurers receive prescriptions, they find it hard to verify because of missing prescriptions, important documents or illegible writing. Telemedicine, on the other hand, generates digital prescriptions that are securely stored and shared with the insurance company instantly to facilitate faster verification and claim settlement.

A Blessing for Rural Areas

One of the biggest challenges for insured individuals in rural areas is accessing quality healthcare, especially during emergencies. Telemedicine helps insured in such remote areas to easily get consultation, diagnosis and treatment options. Their reports are digitally shared with the insurance company, and their claims are settled directly without a physical visit.

Did You Know that, according to a 2024 survey, almost half of the rural Indian population lacks medical insurance, coupled with limited access to quality healthcare facilities? 2

Reduced Chances of Fraud

Telemedicine not only helps the insured but also insurance companies. Fraudulent claims are one of the biggest challenges that insurance companies face. Solution? Telemedicine: It helps generate and store medical records digitally, which cannot be easily tampered with. This helps reduce fraud and misrepresentation in insurance claim settlements significantly.

At the same time, with reduced chances of fraud, the verification process also becomes minimal, thus facilitating faster claim settlement.

Telemedicine in Medical Insurance: The Way Forward

Telemedicine can have several benefits in the insurance space; however, it is still in its initial stages in India. To ensure a smooth and efficient inclusion of telemedicine, here are some aspects that need to be worked on:

Growth of Digital Infrastructure

India lacks proper digital infrastructure to implement telemedicine nationwide, especially in remote areas. A robust digital infrastructure for teleconsultation and data privacy is the next step forward.

Did You Know that the telemedicine market in India is expected to reach $5.5 billion by the end of 2025? 3

Streamlining of Medical Records

There is a need to develop and adopt policies that streamline and standardise medical record keeping. IRDAI and the Medical Council of India (MCI) can sit together to draft robust rules and regulations for insurance companies and hospitals to follow.

Did You Know that during the COVID-19 outbreak, the Medical Council of India (MCI) issued “Telemedicine Practice Guidelines" for the healthcare sector?

Acceptance Across Hospitals and Insurance Companies

To include telemedicine all across the country, there is a need for hospitals and insurance companies, even in the remote areas, to accept telemedicine as a reliable and credible method of medical consultation, diagnosis and treatment.

Pro Tip: Insurance companies can offer discounts to encourage insured individuals to opt for telemedicine and reduce the paperwork while filing a claim.

Summing Up

Advancements in technology have a positive track record for medical insurance companies in terms of offering online policies, verification and now telemedicine for faster claim settlement. Telemedicine has been accepted and included as a part of the claim settlement process by many insurance companies, and it has helped in faster claim settlements.

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