Due to the quick spread of highly-infectious Novel Coronavirus Covid-19, panic-stricken people are feeling insecure and scrambling to take a health insurance cover. However, taking a full-fledged health insurance policy will not only be expensive, but wouldn’t even solve the purpose due to a long waiting period.
In present times, quality healthcare and prompt medical assistance is of utmost importance. The steep rise in Covid cases has resulted in the Insurance Regulatory and Development Authority of India (IRDAI) to compel insurers to launch Covid-specific plans.
Here are the answers to certain essential questions pertaining to health policies in the backdrop of the pandemic by T S Manohar (Executive, New India Assurance Company Limited) and Anshritha Rai (final semester law student of ILS Law College with a keen interest in insurance law) –
Do existing health policies cover Covid-19 hospitalisations?
The existing health insurance policies issued by all general and health insurance companies covers hospitalisation arising out of Covid-19. This has been clarified by IRDAI.
What are the expenses disallowed under existing policies with regard to Covid-19 treatment?
The medical treatment of Covid-19 is slightly different from the treatment of other ailments as it entails medical treatment provided to patients prior to the hospitalisation. The expenses incurred towards gloves, PPE’s, masks, oximeters, oxygen cylinders, nebulisers, AYUSH treatment etc are either disallowed or partially allowed under regular health insurance policies. The reason for this is that such expenses are classified as non-medical expenses. Apart from this, medical treatment expenses of patients who were either home quarantined or treated in Covid care centres are also disallowed if they did not eventually lead to hospitalisations.
What is the rationale behind launching exclusive Covid-19 policies?
As clarified, since certain expenses are not covered by regular health plans, the insured is personally required to bear a sizeable portion of expenses incurred in treatment. As a relief measure, IRDAI had directed all general and health insurance companies to roll out a new product on or before July 10, 2020 to cater to the specific needs of Covid – 19 patients. IRDAI has instructed companies to offer two standard Covid-specific covers – Corona Kavach and Corona Rakshak. Corona Kavach is a mandatory indemnity plan while Corona Rakshak serves as an optional benefit-based plan.
What are the salient features of the Covid specific policies?
So far, all health insurance policies are annual and renewable policies. A distinguishing characteristic of the Covid specific policies is that they are non-renewable and short period policies, ranging from 105 days (3.5months) or 195 days (6.5 months) or 285 days (9.5 months). The age bracket to opt for such a policy is 18-65 years. The plan can cater to a maximum of ten family members. People with co-morbidity can also be covered by paying an additional premium. Importantly, no prior medical examination is required to purchase this policy. It must be noted that a person who has already tested positive will not be benefited under the policy since there is a waiting period of 15 days. The maximum cover offered under Corona Rakshak is Rs 2.5 lakh and Rs 5 lakh for Kavach.
What is the need for a separate Covid health insurance policy?
The novel pandemic is a wake-up call to uninsured persons who are otherwise financially vulnerable. They can avail this policy to take care of their treatment expenses arising out of Covid-19 and avoids out of pocket expenses. In the case of existing health insurance policyholders, holding an additional Covid-specific policy would make the coverage more comprehensive.
Unlike a basic health insurance policy, a Covid specific policy covers medical treatment incurred during home quarantine and at Covid care centres, even if it does not ultimately lead to hospitalisation. Additionally, the policy covers expenses towards PPE’s, masks, gloves, oximeters, oxygen cylinders, nebulisers, AYUSH treatment etc.
A recent survey indicated that consumers are increasingly keen to avail health policies. The unabated spurt in Covid cases has been accompanied with increasing demand for health insurance plans. Understanding the implications of the recent developments introduced in the health insurance sector would help consumers make rational decisions.
