The COVID-19 pandemic has changed the world like never before. While doctors and health experts had a tough time understanding the disease and treating the patients, people were greatly affected due to its communicability. As the death count due to the infection increased daily, people panicked and risked everything to safeguard their lives. Treatment costs surged as experts developed treatment procedures, and the government allowed private hospitals to treat patients due to workforce shortage. Since many policyholders started making insurance claims due to a lack of employment and economic crisis, the insurance industry stumbled. They rejected many claims related to COVID-19 treatment, creating panic among the policyholders. Following the rise in complaints among the insured, the government intervened and directed insurance companies to cover the expenses. They even designed a separate plan to cover the costs related to the COVID-19 treatment and ensured that insurers provide that cover to the public. Thanks to the timely intervention, the insurance policies have brought down the cost of COVID-19 treatment in the country.
Understanding Individual Health Insurance Plans:
An individual health insurance policy is one of the much sought-after policies among the policyholders. The plans are designed to provide health insurance coverage to a single person based on their medical requirements and financial affordability. Under this policy, the insured is entitled to get a cover for hospitalization and other medical expenses. One can also enhance the extent of coverage of the policy by paying for add-ons. Though the coverage is provided only to the insured and not extended to their dependents under the plan, one can add multiple family members to an individual health insurance policy and provide separate coverage for each. A policyholder can make various claims yearly, and many insurance companies will offer a cumulative bonus for every no-claim year. The plan, most of the time, comes with lifetime renewability.
Numerous individual health insurance plans are designed for policyholders. After the COVID-19 pandemic hit the globe, expenses for treating the disease and the number of patients diagnosed with the disease became high. As a result, many insurance companies were reluctant to cover the expense, leaving the patients uncertain. To overcome the hurdle, the Insurance Regulatory and Development Authority of India (IRDAI) has mandated the inclusion of COVID-19 treatment under individual health insurance and family floater policies. One of them is the Corona Kavach policy. It, in turn, has reduced the cost of COVID-19 treatments availed at private hospitals in the country.
Understanding Corona Kavach policy:
Following the COVID-19 pandemic, the IRDAI has mandated all the standalone and general health insurance companies to provide individual COVID standard health policies called ‘Corona Kavach Policy’. It is an indemnity health insurance policy specifically designed to cover COVID-19-related hospitalization, pre- and post-hospitalization, domiciliary, home care treatment and other medical expenses. Treatments unrelated to COVID-19 are not covered under the policy. All the 30 general and standalone health insurers are offering the plan. As per the guidelines, the policy can be availed by anyone aged 18 to 65 years, dependent children from day 1 to 25 years, and people aged above 65 years can also help with the policy as per the company’s product design and underwriting policy.
Following multiple measures taken by the union government, the insurance industry has developed several standard and basic health insurance plans specific to coronavirus to cover hospitalization and other related treatments. The policy is available with a term of three and half months, six and half months and nine and half months, including the waiting period. The policy comes with a waiting period of 15 days. A policyholder can choose an insured sum between Rs 50,000 and Rs 5,00,000.
Benefits covered under Corona Kavach policy:
- Covid-19 hospitalization expenses.
- All COVID claims with or without pre-existing diseases.
- Home care treatment expenses up to 14 days.
- Pre- and post-hospitalization expenses for 15 and 30 days, respectively.
- No sub-limits for room rent, doctor’s fees, medicine and other related expenses.
- Expense of PPE kit, gloves, mask, pulse oximeter, oxygen cylinder and nebulizer.
- No pre-policy health check-up is mandated.
- Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy (AYUSH) treatment expenses.
- As per section 80D of the Income Tax Act, tax benefits are available.
- One can avail hospital daily cash up to 0.5% of the insured sum for every 24 hours of continuous hospitalization for 15 days.
Required documents to claim the expenses:
- Claim form duly filled and signed by policyholder.
- Copy of identity cards and insurance member ID.
- Doctor’s prescription recommending admission.
- Original hospital bills and all payment receipts with a detailed breakup.
- Original discharge summary.
- Original lab and test reports.
- Original medicine bills.
- In the case of home treatment, a doctor’s prescription recommends treatment at home.
- Daily monitoring chart, including treatment records, duly signed by a doctor.
Though it is evident that the policies explicitly designed to cover COVID-19 treatment expenses have brought down medical expenses to a considerable extent, it is always advisable to check and compare the policies of multiple insurance companies before purchasing one. Insurers have made many modifications and are even customizing the policies to tailor-suit a person’s medical requirement and financial affordability since the guidelines were framed.