In order to meet all health insurance requirements, the insurance regulator has advised insurance companies to design products covering the costs of treatment for coronavirus (COVID 19), which has affected thousands of people globally, with several cases detected in India, too. It has also instructed all insurers that where hospitalisation is covered in a product, they have to ensure that the cases related to coronavirus affected patients will be expeditiously handled.

Insurers will have to ensure that the costs of admissible medical expenses during the course of treatment including the treatment during quarantine period are settled in accordance to the applicable terms and conditions of policy contract and the extant regulatory framework. The Insurance Regulatory and Development Authority of India (Irdai) has also underlined that all the claims reported under COVID 19 will be thoroughly reviewed by the claims review committee before repudiating the claims.

Raising awareness
Insurers in India are also taking a number of measures to raise awareness among customers around minimising the spread of coronavirus. Ashish Mehrotra, MD & CEO, Max Bupa Health Insurance, says any policyholder hospitalised for coronavirus condition will be insured under the company’s hospitalisation policies. “We will expedite claims for the treatment of coronavirus patients and provide them all necessary support. The claim process will be similar to other disease conditions. The travel history or family history of the person will not have any impact on the policy and the claim process,” he says. Mehrotra elaborates that in case the policy has an in-built OPD benefit, expenses towards treatment taken at home can be reimbursed as per policy terms.

Insurers are also gearing up for claims. Shreeraj Deshpande, chief operating officer, Future Generali India Insurance, says any person who is hospitalised as a result of coronavirus and takes treatment will be covered as in any other illness. “The subsequent claims will be processed as per regular norms, provided the individual has been hospitalised for 24 hours,” he says.

Amit Chhabra, business head, Health Insurance Policybazar.com, says all health insurance policies will cover hospitalisation expenses. “However, outpatient treatment and quarantine expenses depending on the exact policy wording of the policy,” he says.

Insurers are also evaluating if there is any requirement for a Coronavirus specific cover. Pankaj Verma, head, Market Underwriting Operation, SBI General Insurance says the company’s standard health policy is capable to take care of coronavirus coverage. “Going forward, if the need arises, we will look at bringing out a specific product to address for such diseases as appropriate,” he says.

Go Digit launches COVID-19 cover
As a part of the regulator’s Sandbox product approval guidelines, Go Digit General Insurance has launched a fixed-benefit cover for coronavirus. With a choice of coverage up to Rs 2 lakh, the policy covers ongoing treatment where if the test for COVID-19 is found positive from any of the authorised centres of ICMR – National Institute of Virology, Pune, the insurer will give the policyholder 100% of the sum insured. There is no need to wait for the completion of treatment.

In case of quarantine cases, if the policyholder is quarantined in a government or military hospital for at least 14 consecutive days, the company will pay 50% lumpsum of the sum insured. This is applicable even if the test result is later negative as it covers the screening and treatment costs. The premium for
Rs 2 lakh cover (irrespective to age) is Rs 2,027 plus GST.

However, the policy will not be applicable if a person has travelled to countries such as China, Japan, Singapore, South Korea, Thailand, Malaysia, Hong Kong, Macau, Taiwan, Italy, Iran, Kuwait and Bahrain since Dec 1, 2019. The policy will not cover those above 60 years of age and the policy is terminated after payment of 100% sum insured.

Experts say fast evolving events like the spread of COVID 19 brings to focus the need for innovation and speed in the insurance industry.