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Coronavirus Health Insurance

Coronavirus and Covid-19 have been the buzzwords in the domain of healthcare since the beginning of the year 2020. While Coronavirus is a common name for the viral pathogen called SARS – Cov2 virus, Covid-19 is the name of the disease. Highly infectious by nature, the virus has played havoc by rapidly spreading to all parts of the world in a very short time, causing fatalities in large numbers. As early as January 30, 2020, the World Health Organization (WHO) declared the outbreak of Covid-19 as a global health emergency, which was subsequently termed as pandemic on 11th March, 2020.

By then, it had already infected 110 countries with the potential to spread further. Such a global health emergency is unprecedented in recent times, bringing the world economy to a standstill. By the rate of infection and resultant fatalities, Covid-19 healthcare and Coronavirus Health Insurance cover attained center stage. With the intervention of IRDA in the light of this global health crisis, Indian insurers were prodded to ether include Covid-19 treatment in the existing Health Insurance Plans like any viral infection needing hospitalization, or design dedicated Coronavirus Health Insurance in terms of Regulation Sandbox.

What is Coronavirus Health Insurance?

Though the term Coronavirus Health Insurance is a new entry in the domain of health insurance, it is imperative to comprehend the mechanism of health insurance in general in the first place. Health Insurance is an important component of financial planning which provides financial coverage to protect from health contingencies regardless of the illness, other than those termed as critical. In modern-day, vulnerability to diseases has increased manifold due to lifestyle, food habits, and environmental factors. A suitable health insurance plan is eminently suited for financial preparedness to deal with medical emergencies leading to hospitalization, not only to provide the best of hospital treatment but also to absorb the perpetually rising healthcare cost in the country. And considering the situation of havoc created by this disease, IRDA, the Indian insurance regulatory, advised the inclusion of Covid-19 treatment expenses in the existing Health Insurance policies. Insurers were encouraged to incorporate Coronavirus treatment, being a pandemic free from the description of pre-existing disease. Coronavirus Health Insurance was the immediate result of this advice. Some insurance companies did come up with dedicated Covid-19 Health Insurance for the Indian market. As per provisions of the Sandbox Regulations, Coronavirus Health Insurance was designed for fixed benefit limited period cover, not meant for renewal.

Why Should One Buy Health Insurance for Coronavirus?

Health insurance, in general, is considered a financial protection tool is covering medical emergencies or injury needing hospital care, which is not only costly but also fraught with extreme unpredictability. It imparts a level of financial preparedness to overcome the woes of hospital treatment with some innovative inclusions. These not only help the insured to access the best of healthcare facilities but also overcome physical, mental, and financial stress in full measure. In the case of Covid-19, the rampant incidence, typical of a pandemic, necessitates immediate health insurance cover, if not a dedicated Covid-19 Health Insurance.

Corona Virus Stats

The heightened potential for infection is revealed in the current statistics on its incidence in India as well as globally as on 14th May 2020, within two months of its official declaration as a pandemic by the WHO.  

                                          Covid-19 statistics as on 21 May 2020

Parameters

India

World

Confirmed Cases

112359

4893186

Total Deaths

3435

323956

Total Recovered

45299

-

Total Active Cases

63,624

-

*The above data culled from the official website of WHO and Financial Express for India specific facts.

The magnitude of the global health crisis is evident from the above grid. This has resulted in widespread disruption of the world healthcare system and economy in general, and India in particular. Total lockdown in the country for the preceding 50 days, have arrested the exponential growth of Coronavirus infection, but the strain on the healthcare system is palpable. What can be a better time to be prepared for facing the crisis through a health insurance policy, which covers for Covid-19 treatment protocol, if not a specialized Coronavirus Health Insurance, which has already hit the market?

Types of Coronavirus Health Insurance

As far as the Health Insurance for Coronavirus is concerned, most of the insurers have extended cover to Covid-19 treatment expenses in their existing health insurance. Thus, those who are already insured, automatically come under Covid-19 cover. Typically, these health insurance plans are indemnity types of health insurance, whereas dedicated Covid-19 Health Insurance is a fixed benefit type.

The health insurance comparison between the two types lies in the management of the sum insured. In the case of an indemnity health insurance plan, the cost of hospital care and its related expenses are covered, with the policy remaining in force till the expiry of the term. Benefit health insurance plan, on the other hand, pays the sum insured in a lump sum on detection or diagnosis of the covered disease, and the policy terminates immediately after.

Indemnity - Type Health Insurance with Covid-19 Cover 

Find below the list of insurers offering Covid-19 health insurance in India:

Insurer Name

Plan name

Aditya Birla Capital

Active Assure Diamond Plan

Bajaj Allianz

Arogya Snjeevani Policy for Covid-19

Bharati Axa

Arogya Snjeevani Policy

Chola MS

Arogya Snjeevani Policy

Future Generali

Health Suraksha

HDFC Ergo

All Health Insurance Plans

Max Bupa

Arogya Snjeevani Policy

Manipal Cigna

Arogya Snjeevani Policy

National Insurance

Arogya Snjeevani Policy

Oriental Insurance

Arogya Snjeevani Policy

Care Health (formerly known as Religare)

All Health Insurance Plans

Raheja QBE General Insurance

Arogya Snjeevani Policy

Reliance Nippon Life

Arogya Snjeevani Policy

SBI General

Arogya Snjeevani Policy

Tata AIG

All Health Insurance

United India Insurance

Arogya Snjeevani Policy

Disclaimer: *Paisawiki does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

List of Insurers offering Fixed Benefit Covid-19 Health Insurance

Insurer Name

Plan Name

Digit General Insurance

Arogya Sanjeevani Policy

Future Generali

Group Mediclaim Policy

ICICI Lombard

Covid-19 Protection Cover

Star Health Insurance

Novel Coronavirus Insurance Policy 

Best Covid-19 Health Insurance Plans in India

It is already discussed that there are two types of Health Insurance Plans classified based on how the claims are settled with respect to the sum insured.

  • Indemnity Plans: Expenses of hospital treatment are paid up to the limit of sum insured as per policy terms, and the cover continues till the end of the policy term.
  • Fixed Benefit Plans: The sum insured is paid in full as per policy terms on the diagnosis of the listed illness, regardless of the hospital expenses, and the policy terminates immediately after.

Covid-19 Health Insurance Plans

There are a few pointers to be remembered in terms of Fixed Benefit Coronavirus Health Insurance:

  • As of now, only a handful of general insurance companies have designed specific Covid-19 Health Insurance.
  • These policies also cover those who have tested positive for Covid-19.
  • These policies are offered for a limited period of 1 year as per Sandbox Regulations and cannot be renewed.
  • Only resident Indians are eligible for this policy, other than criteria like age and coverage based on travel history, individual or group-specific to the policy.
  • Sum insured is in the range of Rs.20000 to Rs.200000 with applicable premium from Rs.200 to Rs.2500 at the maximum.
  • These policies are a quick solution to the people who are uncovered by a health insurance plan but would like to be protected against Covid-19.

Best Covid-19 Health Insurance Plans

Considering the above pointers, here’re the details of the dedicated Covid-19 Health Insurance plans are:

  • Digit Health Arogya Sanjeevani Policy

    Launched on April 1, 2020 by the IRDA, Arogya Sanjeevani Policy is designed to offer health insurance coverage for medical expenses, including Covid-19 treatment. Along with the other insurers, Go Digit General Insurance also offers this policy with the following features attached:

    • Anyone for 18 to 65 years can avail this policy
    • Sum insured offered under this plan ranges from Rs.1 lakh to 5 lakh
    • Flat benefit of lump-sum 100% of sum insured in case of Coronavirus positive and 50% in case of quarantine of minimum 14 days in Government or Military Hospital, even if later testing results in negative Coronavirus
    • ICU cover up to a 5% of sum insured or a maximum of Rs 10,000 per day
    • AYUSH treatment cover
    • Initial waiting period is 24 and 48 months, depending on the type of disease.
    • The policy comes with a lifetime renewability option.
    • Multiple individuals can be covered in the policy with appropriate adjustment of the premium.
    • For every claim-free year, 5% of cumulative bonus is offered.
  • ICICI Lombard Covid-19 Protection Cover

    It is a fixed benefit health insurance policy that will pay the sum insured amount on testing Coronavirus positive. If a member is diagnosed with Covid-19 during the policy tenure, the entire sum insured is paid

    • The policy is available to anyone between the age of 18 years to 75 years.
    • Sum Insured offered is Rs.25000.
    • Flat benefit of lump-sum 100% of sum insured in case of Coronavirus positive, regardless of hopitalization expenses.
    • Initial waiting period is 14 days, before which the policy can’t be claimed.

    Add-on:

    • Tele-consultation- 4 free calls with medical practitioners for consultation
    • Ambulance Assistance with a cost of transportation cover

    Exclusions

    • Persons who have traveled overseas after 31st December 2019
    • Persons who have been quarantined or tested positive for Coronavirus prior to the risk inception date
    • Claim arising within the first 14 days after policy inception
  • Future Generali Group Insurance

    It is a fixed benefit plan paying 100% sum insured as a lump sum on testing Coronavirus positive or in case he/she quarantined for coronavirus suspected symptoms. Some of the policy features include:

    Entry Age is 18 years to 75 years, Child: from day 1

    • Sum insured amount to be availed as 10,000, 25,000, 50,000, 75,000, 1,00,000, 1,50,000, 2,00,000, 2,50,000 and 3,00,000
    • 100% sum insured on testing positive
    • 50% on 14-days quarantine for suspected infection
    • Additional 10% of sum assured during quarantine for incidental expenses
    • No medical test required
    • 30 days waiting period is applicable

    Exclusions:

    • Persons with travel history to a country for which Government has issued advisory
    • Any conditions other than Covid-19 infection quarantined phase
    • Persons with a history of Coronavirus
    • Home quarantine
  • Star Health Insurance Star Novel Coronavirus

    This policy covers those who are tested Corovirus positive and need immediate hospitalization.

    • Anyone for the age group of 18 years to 65 years can avail this. Children from 3 months to 25 years of age can be covered with either of the parents.
    • Sum Insured to be availed are Rs 21000 to Rs 42000.
    • Policy premium is starting from Rs 459 + GST to Rs 918 + GST.
    • Flat benefit of lump-sum 100% of sum insured in case of Coronavirus positive at government testing center.
    • Initial waiting period of 16 days is applicable to claim the policy

    Other Features:

    • The policy offered on an individual basis only
    • The policy term is for one year without any renewal
    • The policy can be purchased irrespective of overseas travel
    • No pre-policy medical screening required
    • Can be bought by an individual once in a year
    • The policy will terminate on payment of lump-sum insured
    • There is a free-look period of 15 days

    Exclusions:

    • Claim entertained only on hospitalization regardless of quarantine
    • If there is no hospitalization
    • Claim for Coronavirus infection before the commencement of risk or during the initial waiting period

Features and Benefits of Coronavirus Health Insurance:

The features of fixed benefit Coronavirus Health Insurance policies have already been discussed. However, there is a large number of conventional health insurance policies, which are also referred to as Indemnity Health Insurance cover for hospitalization expenses for treating Covid-19 along with other illnesses or surgeries defined in the policy document. But before elucidating them, it is necessary to look up the features that are common to both the Indemnity and Fixed Benefit type, derived from Health Insurance comparison.

Indemnity Coronavirus Health Insurance

The features and benefits detailed below are very general. This is for the fact that most of the insurers have incorporated treatment of Covid-19 as a necessity for the emerging pandemic. Additionally, IRDAI has prodded about 29 General insurers in the country to offer their standard Arogya Sanjeevani Policy across the country with Covid-19 coverage. 

Some of the Coronavirus specific expenses covered by these plans under hospitalization are detailed below.

  • Room Rent: Usually room rent capping is relaxed in case of Covid-19.
  • Network Hospitals: Cashless hospitalization is available in network hospitals with a pan India spread.
  • Covid-19 Diagnostic Test: Related expenses are admitted in claim
  • Quarantine Hospitalization: Unique to Covid-19 treatment, related expenses are covered and paid
  • In-patient Hospital Treatment: It covers all treatment expenses incurred in the hospital with a stay of consecutive 24 hours or more, including bed rent, OT charges, Pharmacy bills, Consultation and Surgery fees, Diagnostic investigations, cost of surgical equipment and Nursing
  • Pre-and Post-Hospitalization: It covers expenses incurred up to 60 and 180 days, respectively, for pre and post-hospitalization expenses. The coverage days may vary from insurer to insurer.
  • Day Care: Many procedures are treated in the hospital with stay for less than 24 hours due to advances in medical technology. The number of procedures covered and their scope vary with plans and insurers.
  • Restoration of Sum Insured: It is an additional feature where the sum insured is restored to the extent of admissible claim limited to a maximum of the sum insured.
  • Domestic Hospitalization: If the doctor recommends, home healthcare is covered.
  • Ambulance Cover: Road ambulance charges are provided with limits varying with insurers and plans.
  • Recovery Benefit: A lump sum amount up to a specific limit is paid if hospitalization exceeds 10 consecutive days.
  • No Claim Bonus: In the event of consecutive claim-free years, the sum insured is enhanced every policy anniversary date on renewal by 10% to a maximum of 200% of the base sum insured, depending on the insurer.

Additional Benefits

  • Tax Savings: As per provisions of Income Tax Act, 1961, all Health Insurance premium is entitled to deduction under Section 80D. Health Insurance cover for self, spouse, dependent children, and parents are eligible for the deduction.
  • Free Look Period: Irrespective of the type of Health Insurance policy, every plan offers a free-look period. Usually, it is of 15 days from the date of receipt of the policy document, within which it can be canceled, and refund of premium claimed.

Eligibility Criteria for Covid-19 Health Insurance Policy

Other than specific Coronavirus Health Insurance, the eligibility criteria across most insurers are uniform as they offer Covid-19 cover through the standard Arogya Sanjeevani Policy. On the other hand, some insurers cover Covid-19 related treatment expenses in all their existing health insurance plans. 

                        Eligibility for Indemnity-type Health Insurance

 

Minimum

18 years

Maximum

65 years

Children

91 days

 

                       Eligibility for Fixed Benefit-type Health Insurance

Particulars

Eligibility

Minimum Age

18 years

Maximum Age

70-75 years (depending on the insurer) 

Claim Process in Coronavirus Insurance Health Insurance Policies

The claim process again is widely divergent in terms of both types of Health Insurance for Coronavirus.

  • Claim for Indemnity Insurance

    There are two categories of claims. The first is Cashless, and the second is Reimbursement.

    Cashless Hospitalization:

    The cashless hospitalization process is very convenient because the claim is directly settled with the network hospital or healthcare centres. Furthermore, there is a choice of opting from the thousands of network hospitals. Within this category, there are again two types to discuss – Emergency and Planned.

    In both categories, prior intimation is a must. The time frame depends on which kind of claim it is. Intimation can be given both at the TPA desk in the hospital and the toll-free number. The steps for a cashless claim are:

    Intimation at the TPA desk should be along with a valid Health Insurance card or any valid identity card, in its absence.

      • The Hospital forwards the treatment procedure details and the likely cost.
      • The insurer assesses the request and authorizes the treatment as well as the cost involved.
      • After the treatment is over and at the time of discharge, the entire treatment-related documents, investigation reports, bills, etc. are forwarded to the insurer by the TPA desk.
      • After the final authorization is received, if there is any difference in the claim and the approved amount as per terms of the policy, the insured has to pay the shortfall amount to be discharged from the hospital. 

    Reimbursement Claim

    In case of a reimbursement claim, the hospital bills are paid initially and register a claim later. The claim steps are as follows:

    • The appropriate claim form duly completed by the insured and the documents must be furnished to the TPA. The list of claim documents includes:
      • Copy of health insurance card.
      • Hospital bills and their break up in the original.
      • Investigation reports and plates, slides, etc., in the original.
      • Hospital treatment dossier and Doctor’s requisition slips.
      • Copy off the Discharge Summary.
      • Bank account details along with canceled cheque leaf.
    • On receipt of the entire complement of documents, the claim is assessed as per the policy terms and approved.
    • The approved amount is then credited to the beneficiary’s account through electronic transfer within a specific time.
  • Claim for Fixed Benefit Insurance

    Since the claim is explicitly related to Covid-19 and the payout is in a lump sum, the treatment is different from the hospitalization claim described above. In this case, intimation through toll-free numbers or the email of the insurer is mandatory. It is to be remembered that unlike other insurers, Star Health does not employ any TPA, but settle claims themselves. The necessary documents to be submitted along the duly filled in Claim Form are:

      • Copy of health insurance card
      • Quarantine Certificate from a Government Medical Officer
      • A Covid-19 positive virology report from ICMR approved National Institute of Virology, Pune
      • Bank account details along with canceled cheque leaf
      • The payout is electronically remitted to the account of the insured

Inclusion and Exclusions of Coronavirus Health Insurance

With any health insurance plans, the insured needs to be aware of the terms and conditions of the purchased plan. It is possible only when the fine print is comprehended. Ignorance can lead to very stressed claim experience apart from the repudiation of the claim. 

The detailed inclusions and exclusions in fixed benefit dedicated Covid-19 Health Insurance has already been dealt with previously. In the case of indemnity type health insurance for Covid-19, the treatment protocol implies that all the exclusions are not strictly applicable to it. Some noteworthy features are:

Inclusions:

  • Cashless hospitalization
  • Pre and post hospitalization expenses
  • Daycare treatment
  • Domiciliary hospitalization
  • Ambulance cover 

Exclusions:

Since it varies across the insurers, it is imperative to check the individual policy document. Some of the general exclusions are:

  • Initial waiting period
  • Survival period
  • Quarantine at home
  • Quarantine at a non-recognized facility

Renewal of Coronavirus Health Insurance

There is no need for renewing a dedicated Covid-19 Health Insurance Plan as they are offered as per Sandbox Regulation as a Pilot Product for a limited period of one year only. In the case of existing health insurance plans, where Covid-19 treatment has been included as a legitimate claim option, the renewal process is best done online. All the insurer portals provide a tab for the seamless renewal process in a few simple steps.

  • Enter Policy Number
  • Enter Date of Birth and click Proceed / Continue etc
  • The policy details are displayed on the screen, along with the premium amount
  • Pay the premium digitally using the options available.
  • Save the acknowledgment receipt for future reference

How to Buy Covid-19 Health Insurance Policy

Coronavirus Health Insurance Scheme can be bought offline, but the most convenient chosen method of purchase is online. The plan options can be evaluated through an insurance calculator with compare plans online facility. The steps to be used in purchase post compare online are:

  • Click on the “Buy Now” option in the insurer portal
  • Enter basic details like date of birth, gender, smoker or not, Email and cell number
  • Select the appropriate sum insured
  • Select the suitable policy tenure and the mode of premium payment
  • Select the payout option
  • Choose additional riders if any
  • Await the quote
  • Check the quote and if satisfied, pay the accepted premium using available options
  • Complete the other mandatory details in the proposal form which includes health profile
  • Upload requisite documents
  • The purchase is over

Documents Required to Buy Covid-19 Health Insurance

The standard documentation is uniform for both indemnity and fixed benefit covers. The mandatory documents required are listed below.

  • Proof of Identity
  • Proof of date of Birth
  • Proof of Residence
  • Proof of Income
  • Pre policy medical screening reports if applicable

It is also important to note that insurers may call for some specific documents related to any of the plans. In the case of Fixed Benefit Coronavirus Health Insurance, the necessity of pre-policy medical screening is not required. Besides Star Health Insurance, one has to clarify that no foreign travel was involved in the specified periods.

How to Determine a Covid-19 Cover?

In the case of Covid-19, the current situation is volatile and is still evolving. The treatment protocol of the disease also needs special care like isolation, quarantine, and different life support equipment, depending on the prognosis of Covid-19. Furthermore, due to the extremely infectious nature of the pathogen, healthcare providers, and the healthcare infrastructure, need adequate protection. In the case of frontline healthcare personnel, including doctors and nurses, the provision of PPE (Personal Protection Equipment) is mandatory. This makes the treatment of Covid-19 even costlier as the additional cost is passed on to the insured. There is yet a lack of clarity about Coronavirus Health Insurance Policies, which indicates these expenses as a part of in-patient hospital expenses.

Additionally, the treatment protocol for Covid-19 being unique, it is a sensible option to opt for dedicated Covid-19 Health Insurance, which provides a lump sum fixed benefit in the event of the detection of Coronavirus infection. Additionally, there is a partial payout in the quarantine case, regardless of testing negative at the end of it.

Thus, instead of using the usual parameters for assessing the best Health Insurance Plans, it makes sense to opt for Covid-19 Health Insurance Plans on offer in the market. Such readily available plans may be discussed in greater detail in the following paragraph. 

FAQs

Written By: Paisawiki - Updated: 09 October 2020
Disclaimer: Paisawiki does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.