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The outbreak of the novel Coronavirus (COVID-19) has been in the news for two years now. According to the latest figures, currently, the total confirmed COVID cases across the globe are 41,34,80,802 and 58,26,378 lives have been taken away so far (as of February 15, 2022). While multiple variants of Coronavirus have surfaced, the new omicron variant has been identified as the ‘variant of concern’ by the World Health Organization (WHO).
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Currently in India, as of February 15, 2022, there are 4,23,127 active cases of Coronavirus (COVID-19) while the total cases tally is 4,26,92,943. It is a matter of great concern for our vastly populated nation. However, about 4,17,60,458 coronavirus patients have been discharged and cured in the country. The total number of vaccine doses administered in the country till date are 1,73,42,62,440.
Now it is again spreading widely in India as the highly infectious omicron variant has made its way to our country, like Europe and the USA. As of February 15, 2022, more than 10,050 cases of the new omicron COVID variant have been detected in India. Therefore, it is important to be prepared for any unfavourable circumstance in advance. But if you have a health insurance policy, the question is if the novel Coronavirus disease falls under the ambit of medical insurance coverage in India or not?
Novel Coronavirus (COVID-19) is a group of viruses that attacks the immunity of a human being causing diseases ranging from the common cold to Severe Acute Respiratory Syndrome or SARS. In late December 2019, a new strain of coronavirus originated in China, which was unknown to humans before. It came to be known as the novel Coronavirus disease or COVID-19. Several variants of COVID-19 have been detected ever since, including the delta variant and omicron variant.
The coronavirus disease causes infection in the nose, upper throat and sinuses. In severe cases, the virus can lead to major respiratory illnesses such as pneumonia, kidney failure as well as multiple organ failure. Therefore, the 2019-nCoV or the novel coronavirus disease has been fatal largely for people above the age of 60 years and those who had pre-medical conditions.
The symptoms of Coronavirus infection are similar to those of regular flu that includes sore throat, fever, dry cough, runny nose and sometimes a headache. Moreover, the new omicron COVID variant adds extreme tiredness and starchy throat to the list of symptoms. Despite being a new strain of the coronavirus, several COVID-19 vaccines have been developed across the globe, out of which Covishield, Covaxin and Sputnik V is available in India.
Coronavirus Health Insurance refers to an insurance policy that covers the medical expenses incurred on the treatment of COVID-19. A coronavirus health insurance policy is designed to cover the hospitalization expenses of the policyholder, irrespective of the disease that he has been diagnosed with (unless it is a critical illness that is not covered). Almost all the health insurance plans cover hospitalization expenses incurred on the treatment of viral infections. Since Coronavirus is a viral infection, a comprehensive health insurance policy pays off pre & post hospitalization expenses including in-patient and out-patient expenses, incurred on the treatment of COVID-19 and its variants, including omicron.
Health insurance for coronavirus cover will be available from the day the insured gets diagnosed with the disease. This is because COVID-19 is a new disease and therefore, does not come under the category of pre-existing illness.
Some of the major benefits of Coronavirus Health Insurance are listed below:
|
Coronavirus Treatment |
Covered with zero additional cost |
|
Home Treatment |
Covered if suggested by a doctor |
|
Consumable Expenses |
Cost of PPE kits, ventilators, masks, gloves, |
|
Co-payment |
Age based Co-pay is not there in most of the plans |
|
Cashless Treatment |
Available |
|
Add-on Covers |
Available |
If you are looking for a specific health insurance cover for coronavirus (COVID-19) then you can consider standard health insurance policy that cover all medical expenses incurred during the treatment of COVID-19. These are two standard products that have been recently launched as per the IRDAI guidelines. And the policy terms remain the same across all the health and general insurance companies in India. Checkout out both COVID-19 health insurance plans types along with the policy benefits:
Corona Kavach Policy is a standard coronavirus health insurance policy that covers hospitalization expenses, home care treatment cost, ambulance charges, cost of PPE kits, medicines, gloves, masks, doctor fees, ICU charges incurred during the treatment of COVID-19 pandemic. The sum insured amount starts from Rs 50,000 and goes up to Rs 5 Lakh. You can get your family covered under this plan that also pays for Ayush treatment in India.
Corona Rakshak Policy is also a COVID-19 specific health insurance policy that pays for hospitalization of a minimum of 72 hours and more as required for COVID-19 treatment in India. The policy covers expenses incurred towards PPE’s, nebulizers, masks, oxygen cylinders, gloves, oximeters, AYUSH treatment, etc. that are limited under a regular medical insurance policy. This COVID-19 insurance policy is available to individuals between the age group of 18-65 years on an individual sum insured basis that ranges from Rs 2.5 lakh to Rs 5 Lakh. Applicants with co-morbidity can also get insured paying an additional premium.
If you are covered under a group health insurance policy, then you need to check with your insurer if it covers coronavirus treatment expenses. However, if your group health insurance policy is either Corona Rakshak or corona Kavach then you are surely covered for the COVID-19 hospitalization in India.
Since the outbreak of coronavirus, many insurers have been offering Covid-19 Health Insurance cover in their base plans. They are also providing specific Covid-19 Insurance Plans, Corona Kavach and Corona Rakshak are two such indemnity and benefit based plans that have been popular with people in India. All the hospitalization expenses, Ayush treatment expenses, and home treatment expenses are covered along with the cost of consumable items in these two mediclaim policies for coronavirus.
| Insurance Companies | Sum Insured (₹) | Incurred Claim Ratio (2022-23) |
| Aditya Birla Health Insurance Company Limited | Min – 2 lakh Max – 2 crore |
64.68% |
| Bajaj Allianz General Insurance Company Limited | Min – 1.5 lakh Max – 1 crore |
74.27% |
| Care Health Insurance (Formerly known as Religare Health Insurance) Limited | Min – 1 lakh Max – 6 crore |
53.82% |
| Cholamandalam MS General Insurance Company Limited | Min – 1 lakh Max – 25 lakh |
67.88% |
| Future Generali India Insurance Company Limited | Min – 50,000 Max – 10 lakh |
79.18% |
| Go Digit General Insurance Limited | Min – 2 lakh Max – 3 crore |
71.87% |
| HDFC ERGO General Insurance Company Limited | Min – 5 lakh Max – 2 crore |
79.04% |
| ICICI Lombard General Insurance Company Limited | Min – 5 lakh Max – No age limit |
77.33% |
| IFFCO Tokio General Insurance Company Limited | Min – 1.5 lakh Max – 30 lakh |
111.18% |
| Liberty General Insurance Limited | Min – 2 lakh Max – 15 lakh |
74.17% |
| Magma HDI General Insurance Company Limited | Min – 2 lakh Max – 3 crore |
72.10% |
| ManipalCigna Health Insurance Company Limited | Min – 2.5 lakh Max - 1 crore |
64.66% |
| National Insurance Company Limited | Min – 1 lakh Max – 10 lakh |
102.35% |
| New India Assurance Company Limited | Min – 2 lakh Max – 15 lakh |
103.33% |
| Niva Bupa Health Insurance (Formerly known as Max Bupa Health Insurance) Company Limited | Min – 5 lakh Max – 1 crore |
54.05% |
| Raheja QBE General Insurance Company Limited | Min- 1 lakh Max – 50 lakh |
138.67% |
| Reliance General Insurance Company Limited | Min – 3 lakh Max – 5 crore |
86.31% |
| Royal Sundaram General Insurance Company Limited | Min – 2 lakh Max – 50 lakh |
83.36% |
| SBI General Insurance Company Limited | Min – 3 lakh Max – 2 crore |
73.92% |
| Star Health & Allied Insurance Company Limited | Min – 3 lakh Max – 25 lakh |
65% |
| Tata AIG General Insurance Company Limited | Min – 5 lakh Max – 3 crore |
78.33% |
| The Oriental Insurance Company Limited | Min – 1 lakh Max – 50 lakh |
130.09% |
| United India Insurance Company Limited | Min – 3 lakh Max – 25 lakh |
89.57% |
| Universal Sompo General Insurance Company Limited | Min – 1 lakh Max – 50 lakh |
82.84% |
| Zuno General Insurance Company Limited | Min – 1 lakh Max – 1 crore |
89.59% |
| Zurich Kotak General Insurance Company (India) Limited | Min – 2 lakh Max – 25 lakh |
56.01% |
*Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. This list of plans listed here comprise of insurance products offered by all the insurance partners of Policybazaar. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in.
Coronavirus disease or COVID-19 may be a newly discovered disease but all existing health insurance policies will provide coronavirus health insurance cover. This means that if you purchased a health insurance policy before testing positive for the coronavirus disease, any medical expenses incurred on its treatment will be covered under it (provided you don’t get diagnosed during the initial waiting period). You can avail coverage for coronavirus under your existing health insurance policy irrespective of the variants i.e. omicron or delta variant.
Since the coronavirus is not a pre-existing ailment, it will be covered as part of the basic hospitalization expenses under a health insurance plan that includes in-patient hospitalization expenses, ICU charges and diagnostic test charges amongst others.
However, if you don’t already have a health insurance policy and decide to buy one after testing positive for COVID-19, then coronavirus treatment expenses will not be covered under the policy.
The following table shows the list of inclusions under coronavirus health insurance:
| Important Covers | Standard Covers | Add-on Covers |
|
|
|
Not all medical expenses are covered under your coronavirus (COVID-19) health insurance policy. Take a look at the list of exclusions under your coronavirus insurance:
|
Social Distancing |
Self-Isolation |
Quarantine |
|
Avoid going to crowded places, meeting people, social gatherings like marriage, funeral, visiting someone’s home, public place or a medical facility until it’s necessary |
If you think you have met someone who is COVID-19 positive or feel unwell or have a travel history to affected countries then you can take protective measures and isolate yourself from others to limit the transmission of the virus |
Anyone who has mild symptoms that can be treated at home is Quarantined at home or if serious is quarantined in a hospital and is kept under medical observation. The patient can do it himself or can be done by Government Authorities those who have a travel history overseas or have been in contact with a COVID positive person |
There are two ways of filing a health insurance claim for Coronavirus disease. The claim settlement process for Coronavirus health insurance & the other health insurance policy like Arogya Sanjeevani Policy is almost same. You can file a cashless claim or a reimbursement claim. Let us read in detail about both types of claims for coronavirus health insurance cover:
Most health insurance providers today provide cashless treatment facility. As part of this facility, the insured is not required to make any payment for the treatment taken at one of the network hospitals of the insurer. Instead, the insurance company settles the treatment bills directly with the hospital.
So if you receive treatment for coronavirus (COVID-19) disease at a network hospital of your insurance provider, you will be able to avail cashless treatment facility and would not be required to make any payment for the treatment received.
Make sure to check if your health insurance for coronavirus offers cashless claim facility. You can find the list of network hospitals of your insurer on the policy wordings or at the official website of your insurance provider.
Reimbursement claims are meant for policyholders who get hospitalized and receive treatment at a non-network hospital of his insurance provider. If you obtain treatment for COVID-19 at a non-network hospital of your insurer, you will be required to pay all the hospital bills in full at the time of your discharge.
Once you get discharged, you need to file a reimbursement claim with your insurance provider. To do so, you’ll have to fill up the reimbursement claim form and submit the required documents including the hospital bill payment receipts, investigation & test reports and doctor’s prescription to the insurer within the specified time limit.
The insurance company will verify your claim and post that the reimbursement amount will be transferred to your bank account.
Before you buy a coronavirus insurance India is offering, you should be aware of a few facts related to the policy. Here are some important facts that you should know before buying a coronavirus health insurance which covers COVID-19:
The Insurance Regulator further advised all the insurance providers to make sure that wherever Corona Specific standard health insurance products have been filed and approved by IRDAI, they should be provided to the applicants as per the insurer’s underwriting policy. Also, where the Corona health plans enable the policyholder to renew the policy, the insurance companies have to renew such plans subject to the underwriting policy of the respective insurance providers.
The PMGKP scheme provides Rs 50 lakh health cover to the health warriors who lost their lives to the COVID-19 disease. As per MoHFW health insurance cover of up to Rs 50 Lakh is provided under the scheme and nearly 287 claims have been paid by the Insurer so far. Now the date has been extended for another year to ensure that the healthcare workers have a safety insurance net.
Moreover, the insurance companies also arrange to vaccinate their employees and agents as well.
In a letter to the insurance providers, IRDAI has asked them to make special arrangements for vaccinations for their policyholders either as a group or individual at a government facility or a private facility as per their policy option. IRDAI said the insurers can create awareness regarding the vaccination by sending SMS or email to the policyholders.
And, they should also assist the policyholder to get vaccinated as a group in an orderly manner by pre-booking slots in advance. Also, they should provide them with the second vaccine shot.
Moreover, the insurance companies also arrange to vaccinate their employees and agents as well.
The information is based on the IRDAI’s circular issued on March 24, 2021. Corona Kavach is a Standard Indemnity based products and Corona Rakshak is a Standard benefit-based product dated 26 June, 2020. All the insurers will now offer renewal up to 30 September 2021.
Currently, these coronavirus health insurance products can be purchased for tenure of 3.5 months, 6.5 months and 9.5 months, i.e. 105, 195, and 285 days respectively.
In a recent hearing on May 15, 2020, the Indian Government told the Bombay High Court to extend the health insurance coverage offered under Pradhan Mantri Garib Kamgar Package, to essential services, civic workers working in contract, and people who may encounter Coronavirus positive patients. The scheme offers coverage of Rs 50-lakh to Health Workers.
This health insurance scheme will cover every person on Covid-19 duty, who get infected from other COVID positive patients. This scheme shall benefit all the frontline healthcare workers in both public and private establishments and for both contractual and permanent employees. It also offers death cover. Therefore, the scheme will also cover eligible contract employees of NMMC.
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Read more*We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30- minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881.
*Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. Policybazaar does not provide any medical or surgical advice or diagnosis and is not responsible for your interactions / treatment by a medical practitioner/hospital. Please consult a registered medical practitioner for any medical or surgical advice. The Information that you obtain or receive from Policybazaar, and its employees, or otherwise on the Website is for informational purposes only. As per the Insurance guidelines, you are allowed to cancel the policy with-in 30 days from the date of Issuance of policy.This option is available incase of policies with a term of one year or more.
*All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.
**All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws. GST Exemptions depend on fulfilment of qualification criteria and submission of relevant documents.
*₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.
*₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases
*₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases
*₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases
*₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases
*₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.
*₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.
*No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.
*The values taken for effective cost calculation are indicative values and may change as per the selected plan.
*Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.
*Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.
*The scope of coverage may vary from plan to plan.
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##On ground claim assistance is available in 114 cities
Tax Benefits are subject to changes in tax laws. GST Exemption depends on fulfilment of qualification criteria and submission of relevant documents as required by the insurers. For more details on risk factors, terms and conditions, please read the sales brochure and applicable rules and regulation carefully before concluding a sale.
STANDARD TERMS AND CONDITIONS APPLY. For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale.
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