Health Insurance in the times of COVID

The year 2020 will forever be remembered as a crucial time in history. Seven months into it, the pandemic is still looming around most of the world and while cases are still rising, we’ve all evolved from being extremely fearful of the unknown to now learning how to live with it. This is the new normal as we all say today. On the surface of it, it may seem like things are slowly easing into normalcy but the reality on ground is actually very different. In India specifically, cases are still increasingly rising, and experts suggest that we have not yet reached the peak, which is scary!

Currently, at more than 13,90,000 confirmed coronavirus cases and India now being one of the countries with highest active coronavirus cases, it is now more crucial than ever to take necessary precautions to ensure we’re in the pinkest of health.

This doesn’t mean steering away from the virus alone but staying protected from all other illnesses as well, given that with so many active cases today, healthcare facilities in India are already overwhelmed.  The coronavirus hasn’t only brought to life a contagious and deadly virus but, also other repercussions such as financial instability and the global and national economic slowdown.

This evidently means you don’t only have to protect yourself from the virus and other illnesses but, also ensure you are financially secure and one of the means of doing so is, getting a health insurance for coronavirus and other illnesses too.  This won’t only help cover for your healthcare expenses (whether it is coronavirus or something else too) but will also ensure you aren’t faced with any financial burdens at such a point.

It is in this regard the Insurance Regulatory Development Authority of India (IRDAI) announced the guidelines for two standard COVID-19 health insurance policies with uniform features, terms and conditions, the insurance companies have begun offering ‘Corona Kavach’ and ‘Corona Rakshak’ from July 10 and help people with better health insurance coverage in their fight against the coronavirus pandemic. It is mandatory for general and health insurers to provide the reimbursement-based standard COVID-19 product, while offering the benefit-based product is optional for all insurers.

Despite being coronavirus-specific policy, the regulator said, the standard indemnity-based COVID-19 policy named as ‘Corona Kavach’ will cover the cost of treatment of any co-morbid conditions, including pre-existing conditions, along with the treatment for the coronavirus infection or disease with the tenure ranging from 3.5 months to 9.5 months. Notably, an indemnity plan reimburses hospitalisation expenses actually incurred by the policyholder to the extent of the sum insured.

Further, all life, general and health insurance companies have been encouraged to offer standard benefit-based policy, ‘Corona Rakshak’, which hands out a pre-agreed lump-sum upon diagnosis. The premium under both the products shall be pan India basis and no geographic location or zone-based pricing will be allowed, according to the IRDAI. Commenting on the regulator’s guidelines on uniform COVID-19 health insurance products, Bharti AXA General Insurance Chief Underwriting and Reinsurance Officer Milind V. Kolhe said, “We welcome the regulator’s move to bring the COVID insurance products at the time when it is needed the most. Customer-centricity is the main theme of these products during the unprecedented times.

“The hallmark feature is the uniformity of the policy wordings across the market. Claims management will be an important aspect of these products and insurers are working closely with the General Insurance Council to bring some rationalization in the treatment costs. As a responsible insurer, we are fully committed to creating innovative and productive solutions for the customers in an appropriate manner.”

According to the guidelines by the IRDAI, the minimum sum insured for the Corona Kavach Policy will be Rs 50,000 and the maximum sum insured would be Rs 5 lakh. There is also a five per cent discount for healthcare workers. However, for Corona Rakshak Policy, the minimum sum insured would be Rs 50,000 and maximum limit is set at Rs 2.5 lakh.

Corona Kavach policy is an indemnity-based policy, but optional cover shall be made available on benefit basis. The base cover will offer hospitalization expenses like room and boarding charges along with PPE kits, gloves, masks and such other similar expenses and even AYUSH treatment.

Corona Kavach also covers home care treatment expenses of up to 14 days, if it involves an active line of treatment and is done on a medical practitioner’s advice, among other conditions. Cost of pulse oximeter, oxygen cylinder and nebulisers will also be covered.

Corona Rakshak, the single-premium plan will pay out 100 per cent of the sum insured as lump-sum if the policyholder is hospitalised — at least for 72 hours — after testing positive for COVID-19. The sums insured under the product, which will carry tenures of 105 days, 195 days and 285 days, will range from Rs 50,000 to Rs 2.5 lakh. The policy will cease to exist once the claim is paid out.

The minimum entry age for both the policies shall be 18 years and the maximum is 65. Dependent children shall be covered from the age of three months to 25 years. However, only the indemnity policy comes with the family floater option. The policy tenure could be 3.5 months, 6.5 months or 9.5 months, including the waiting period, and health insurance rules such as lifelong renewability, migration, and portability shall not be applicable to these products.