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Coronavirus - Does my existing Health Insurance Cover it? Can I buy a Coronavirus Specific Health Insurance Plan?

Rohit Sapra Rohit Sapra 16 March 2020

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Coronavirus has finally landed on the Indian soil and started spreading its deadly grip. Along with this, there is also an increase in anxiety among the masses, everybody wants to know whether their health insurance claims would be honoured if they fall prey to this disease.

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As on the 16th March 2020, India has recorded a total of 114 Coronavirus positive cases which includes 97 Indian nationals and 17 Foreign Nationals. India has also recorded 2 deaths in the states of Delhi and Karnataka. This rise in Coronavirus cases has flooded the health insurance providers with queries regarding their existing health insurance policies or do they need to buy a Coronavirus specific health insurance plan. There has also been a significant increase in the demand for new health insurance for covering oneself and their loved ones.

In this article, we have tried to answer two primary questions related to coronavirus health insurance and claims

  • Does your existing health insurance plan cover claims related to Coronavirus?

    • A standard health insurance plan provides coverage towards hospitalization, surgical, pre and post hospitalization expenses, room rent, ambulance charges, etc.

    • For Coronavirus related cases the test procedure undertaken toward confirmation of COVI-19 are currently free i.e. the government bears these expenses. In case a person holding a health insurance policy gets hospitalized due to coronavirus for a period of more than 24 hours only then such patients hospitalization, surgical, post-hospitalization expenses, room rent, ambulance charges.

    • In this regard, even the regulatory body of life insurance in India i.e. Insurance Regulatory and Development Authority of India (IRDAI) has issued guidelines through its circular dated 04th March 2020. IRDAI has asked insurers to expeditiously handle Coronavirus related cases where hospitalization is covered. It has also asked the insurers to settle the expenses related to admissible medical expenses occurred during the course of treatment including the quarantine period as per the applicable terms and conditions of the policy and extent of the regulatory framework. Also, the insurers claim review committee must thoroughly review all the claims related to Coronavirus or COVID-19 before repudiating them.

  • Can I buy a Coronavirus Specific Health Insurance Plan?

    • Yes, in the circular mentioned above IRDAI has also asked the insurers that to provide need-based health insurance coverage, insurers are introducing products for various specific diseases, including vector-borne diseases. For the purpose of meeting health insurance requirements of various sections, insurers are advised to design products covering the costs of treatment for coronavirus.

    • Digit Insurance has recently launched a Need Based Insurance against Coronavirus. This cover is offered under its Digit Health Care Plus Plan. One can choose this policy if their age ranges from 18 to 60 years. A policyholder can choose a sum insured within the range of minimum Rs. 25,000 to maximum Rs. 2 Lakhs. The policy is available on an individual basis only, in case the policyholder is diagnosed with coronavirus the sum insured up to 100% is paid. In case, the patient is quarantined in a government or military hospital 50% of the sum insured is paid. This feature has a waiting period of just 15 days and is available under Section 12 of the Critical Illness Benefit Cover offered under Digit Health Care Plus Policy.

One has to provide information on whether

  • the Insured and/or Insured Members Proposed have travelled to China / Japan / Singapore / South Korea / Thailand / Malaysia /Hong Kong /Macau/ Italy/ Iran/ Taiwan/ Kuwait/ Bahrain since 1st December 2019

  • Is the Insured and/or Insured Member(s) suffering from any respiratory-related symptoms like severe cough, respiratory distress, breathlessness from last 4 weeks.

  • If the answer to the any of the above questions is a yes then the policy is not issued. This experimental product is launched under IRDAI’s Regulatory Sandbox Regulations 2019 for a limited period of time.

  • If one has a health insurance policy one can be relaxed that if unfortunately, they require treatment against coronavirus then their medical expenses will be taken care of by the insurer. It is wise to get oneself covered with a health insurance plan, if one does not have health insurance, they can buy a plan which covers the same and that too with a limited waiting period of just 15 days.

Recommended Link: Coronavirus or COVID-19 here’s all you need to know about it

Rohit Sapra
Written by Rohit Sapra
Rohit Sapra, a licentiate, and currently an SME, is a seasoned insurance professional with previous work experience from Kotak and Birla Sun Life Insurance.