COVID 19 : Medical Insurance Brief details : Health Insurance Scheme
CORANA : As the number of coronavirus cases surge across country, health insurers like Star Health and Allied Insurance, ICICI Lombard, Bharti Axa Health, and Reliance General Insurance have rolled out covid-specific policies. Digit insurance too offered a similar product under the insurance regulator’s Sandbox regulation, but has now opened it for retail.
Most of these policies are being offered at attractive premiums and are fixed-benefit products. The policies come with sum insured ranging between ₹25,000 and ₹1 lakh. However, covid-19 claims received by insurers have gone as high as ₹7 lakh. If you plan to buy one such covid-specific health insurance policy, keep these things in mind.
SUM INSURED :
If you do test positive for covid-19, the cost of treatment will depend on the severity of your condition. If the patient is critical and requires ICU and ventilator facilities, the cost of treatment could be very high. Most of the covid-specific insurance policies offer a cover in the range of ₹25,000-1,00,000 and may not be sufficient if you get hospitalised. However, since a majority of these are defined-benefit policies, you will get the complete sum insured but the requirement for making a claim varies from company to company. Digit Insurance, for example, will allow policyholders to make a claim on testing positive for covid-19 and sending the samples for diagnosis to National Institute of Virology, Pune or its affiliated centers whereas Star Health will make a payment only on hospitalisation and report of positive diagnosis from government-authorised centres.
EXCLUSIONS :
It’s important to take a close look at the fine print before buying a disease-specific policy because very often, such policies come with a host of exclusions leaving very little room for the policyholder to be able to file a claim. Most of these policies are valid for a period of one year but may come with exclusions such as no travel history to a list of countries after 1 December 2019, policyholders having symptoms such as cough, cold or nasal block, fever, and shortness of breath may not be eligible as well. Some policies may not allow policyholders to make a claim without 24 hours of hospitalisation.
WHO SHOULD GO FOR IT?
Rakesh Goyal, director, Probus Insurance, an insurtech broking company said it is highly advisable to have a regular health cover. However, someone who doesn’t have a health policy can consider buying such a policy but only after understanding the exclusions. “There are a number of exclusions therefore, one must carefully understand the product before buying. It’s better to have some insurance cover rather than having nothing at all. At least some cost of treatment will be covered if tested positive," said Goyal.
Mint recommends going for a standard health policy with adequate sum insured. In case, the cost of treatment is high (as is being reported in some cases), the policy will cover you for most of the expenses. Also, many regular health insurance policies now cover pre and post hospitalisation expenses as well. You can consider buying a top up if you feel the existing sum insured may not suffice.
“Limited cover is a drawback in covid-specific policies. Also, remember that if the policyholder has other pre-existing ailments, then such an individual may not get covered in a benefit-based policy for covid-19. Therefore, having a regular health plan is a must in these testing times," said Pankaj Chauhan, MD and CEO, EPOCH Insurance Brokers Ltd.
CORANA : As the number of coronavirus cases surge across country, health insurers like Star Health and Allied Insurance, ICICI Lombard, Bharti Axa Health, and Reliance General Insurance have rolled out covid-specific policies. Digit insurance too offered a similar product under the insurance regulator’s Sandbox regulation, but has now opened it for retail.
SUM INSURED :
If you do test positive for covid-19, the cost of treatment will depend on the severity of your condition. If the patient is critical and requires ICU and ventilator facilities, the cost of treatment could be very high. Most of the covid-specific insurance policies offer a cover in the range of ₹25,000-1,00,000 and may not be sufficient if you get hospitalised. However, since a majority of these are defined-benefit policies, you will get the complete sum insured but the requirement for making a claim varies from company to company. Digit Insurance, for example, will allow policyholders to make a claim on testing positive for covid-19 and sending the samples for diagnosis to National Institute of Virology, Pune or its affiliated centers whereas Star Health will make a payment only on hospitalisation and report of positive diagnosis from government-authorised centres.
EXCLUSIONS :
It’s important to take a close look at the fine print before buying a disease-specific policy because very often, such policies come with a host of exclusions leaving very little room for the policyholder to be able to file a claim. Most of these policies are valid for a period of one year but may come with exclusions such as no travel history to a list of countries after 1 December 2019, policyholders having symptoms such as cough, cold or nasal block, fever, and shortness of breath may not be eligible as well. Some policies may not allow policyholders to make a claim without 24 hours of hospitalisation.
WHO SHOULD GO FOR IT?
Rakesh Goyal, director, Probus Insurance, an insurtech broking company said it is highly advisable to have a regular health cover. However, someone who doesn’t have a health policy can consider buying such a policy but only after understanding the exclusions. “There are a number of exclusions therefore, one must carefully understand the product before buying. It’s better to have some insurance cover rather than having nothing at all. At least some cost of treatment will be covered if tested positive," said Goyal.
Mint recommends going for a standard health policy with adequate sum insured. In case, the cost of treatment is high (as is being reported in some cases), the policy will cover you for most of the expenses. Also, many regular health insurance policies now cover pre and post hospitalisation expenses as well. You can consider buying a top up if you feel the existing sum insured may not suffice.
“Limited cover is a drawback in covid-specific policies. Also, remember that if the policyholder has other pre-existing ailments, then such an individual may not get covered in a benefit-based policy for covid-19. Therefore, having a regular health plan is a must in these testing times," said Pankaj Chauhan, MD and CEO, EPOCH Insurance Brokers Ltd.
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