Starting 10 July, you will be able to purchase standardised short-term health insurance policies for COVID-19 with uniform features, terms and conditions, from any insurer of your choice. These will be available as indemnity, or reimbursement plans with general insurers or benefit-based plans with life insurers.
The Insurance Regulatory and Development Authority of India (IRDAI) on 26 June had finalised the guidelines for these health insurance policy focusing on COVID-19.
After introducing standardised health plan Aarogya Sanjeevani, the insurance regulator has ordered for simple COVID-19 based policies so as to not overwhelm first-time policy buyers with insurance jargons and wide range of health plans.
The standard indemnity-based COVID-19 policy will be named 'Corona Kavach', followed by the name of the insurance company. All general and health insurers (except ECGC & AIC) in the health insurance business have been ordered to mandatorily offer the COVID Standard Health Policy, also called the Corona Kavach Policy, by IRDAI.
- The policy will have one basic indemnity-based mandatory cover and one optional cover that will be benefit based.
- On the basic cover, the sum assured will range from Rs 50,000 to Rs 5 lakh and will come with short term tenures of three-and-half months, six-and-half months and nine-and-half months, including the waiting period.
- Those aged between 18 and 65 years can purchase this health plan. It will also be purchased as a family floater to include spouse, dependent children (up to 25 years), parents and parents-in-law.
- It would be a single premium policy without lifelong renewability benefits.
- Apart from COVID-19 treatment, it shall include the cost of treatment for any comorbid condition including pre-existing comorbid conditions.
- No deductibles are permitted in this product.
The base cover will include:
1) COVID-19 hospitalisation charges- that is hospitalisation expenses actually incurred by the policyholder to the extent of the sum insured on the treatment of COVID-19, after being diagnosed positive for the infection in a government authorized diagnostic centre. It will cover:
- Room, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home.
- Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees (including consultation through telemedicine) whether paid directly to the treating doctor/surgeon or to the hospital.
- Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, ventilator charges, medicines and drugs, costs towards diagnostics, diagnostic imaging modalities, PPE Kit, gloves, mask and such other similar expenses
- Expenses on hospitalization for a minimum period of 24 hours are admissible.
- Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses. Expenses incurred on road Ambulance subject to a maximum of Rs 2,000 per hospitalization.
2) Home care treatment- Cover on costs of home treatment up to a maximum of 14 days per incident is covered, if the medical practitioner has advised such treatment, among other policy conditions. It will cover expenses incurred on diagnostic tests, medicines, nursing staff, consultation, cost of Pulse oximeter, Oxygen cylinder and Nebulizer.
3) Pre-hospitalisation- medical expenses incurred for a period of 15days prior to the date of hospitalization/home care treatment following an admissible claim under this policy shall be covered. Pre-hospitalization expenses shall also cover the costs of diagnostics towards COVID-19.
4) Post-Hospitalization medical expenses incurred for a period of 30 days from the date of discharge from the hospital/completion of home care treatment, following an admissible claim under this policy shall be covered.
Hospital Daily Cash- The insurance company will pay 0.5 percent of sum insured per day for each 24 hours of continuous hospitalization for treatment of COVID-19 following an admissible hospitalization claim under this policy. The benefit shall be payable maximum up to 15 days during a policy period for every insured person.
The benefit-based policy will be termed 'Corona Rakshak' followed by the name of the insurance company. It hands out a pre-agreed lump-sum upon diagnosis. The Corona Rakshak product can be provided by all Insurers (General, Health and Life) transacting Health Insurance business if they wish to.
- It is a single premium plan with lump sum payout of 100 percent of the sum assured if those insured are hospitalised for at least 72 hours after testing positive for COVID-19 at a government-authorised diagnostic centre.
- On payment of 100 percent of the sum insured the policy shall be terminated..
- Tenure options: 105 days, 195 days and 285 days
- Sum assured: between Rs 50,000 to Rs 2.5 lakh
- Lifelong renewability, migration and portability features will not be available.
- There will not plan variants allowed to be offered by insurers.
- The policy will be offered on individual basis only.
While features will remain the same among insurance companies, premiums will vary. You can decide on the plan based on the services like cashless hospital network by the insurer and premium costs.