Telemedicine Insurance Issues represent one of the most complex and critical components of the digital health ecosystem. In Georgia, where private and state insurance systems function in parallel, reimbursement for remote medical services is often ambiguous. Problems arise for both patients (does my policy cover online visits?) and medical providers (how to get reimbursed by the insurer for remote services?). Furthermore, professional liability insurance for doctors is critically important. Traditional insurance policies often do not account for the specific risks of telemedicine, such as diagnostic errors caused by technological glitches or cybersecurity breaches. This service helps clinics, insurance companies, and doctors legally regulate insurance relationships in the digital space.
Specialists on Legal.ge offer in-depth legal support regarding telemedicine insurance, including:
- Insurance policy audit: Analyzing existing contracts and developing recommendations to cover telemedicine services.
- Provider agreements: Drafting contracts between clinics and insurance companies that detail tariffs and reimbursement conditions for online services.
- Professional liability insurance: Consulting on specialized insurance (Malpractice Insurance) that covers risks of remote practice.
- Cyber risk insurance: Legal mechanisms for compensation of damages caused by data leaks or hacker attacks.
- Dispute resolution: Protecting interests during disputes with insurance companies regarding refusal to reimburse telemedicine services.
In practice, misunderstandings are common when a patient believes their insurance covers online consultations, but the insurance company refuses reimbursement on the grounds that a "visit" is defined as a physical meeting. The issue of doctor liability is also problematic: if a doctor misdiagnoses online due to poor video quality, does standard insurance cover this? In many cases — no, leaving the doctor vulnerable to financial loss. Another scenario involves cross-border services, where insurance companies categorically refuse to reimburse remote services provided abroad without a prior agreement.
In Georgia, the insurance sector is regulated by the Law "On Insurance" and the Civil Code. Although legislation does not explicitly prohibit telemedicine insurance, it also imposes no specific obligations on insurers. Under the state universal healthcare program, reimbursement for telemedicine is still evolving, although certain services (e.g., family doctor phone consultations) became reimbursable following the COVID-19 pandemic. In the private insurance sector, relationships are primarily based on the principle of freedom of contract, making the involvement of a qualified lawyer essential to clarify contract terms.
Working with a specialist begins with risk assessment. For clinics, the lawyer develops a standard for documenting online visits (Form IV-100/a) so that the insurance company lacks formal grounds to refuse reimbursement. For doctors, the lawyer identifies and evaluates insurance products that genuinely protect them during digital practice.
Legal.ge is your reliable partner in healthcare law and insurance. Telemedicine is developing rapidly, and insurance disputes are becoming more frequent. Through our platform, you can connect with lawyers experienced in both medical and insurance law, ensuring the protection of your financial interests.
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