Max Bupa Corona Kavach Policy

Max Bupa corona kavach policy is a coronavirus specific indemnity based medical insurance plan that reimburses the cost of Coronavirus treatment in India. The Policy offers Basic mandatory coverage that is offered on indemnity basis and one optional cover that is offered on benefit Basis. The policyholder needs to pay the premium for optional cover will separately. Being an indemnity insurance policy it pays the claim amount as per the hospital bills, whereas on benefit bases the policyholder get the entire sum insured amount. Check out the details about Max Bupa Corona Kavach Policy, its features, benefits and limitations.

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Max Bupa Corona Kavach Policy

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    Key Features and Benefits of Max Bupa Corona Kavach Policy

    This policy is designed with unique combination of medical insurance benefits and features to its customers:

    • Digital Health Insurance Policy: It is a digital health insurance policy as the policyholder will only receive a digital copy of this policy with all the details, instead of a physical copy.
    • Policy Term: Flexibility in policy terms is offered, and the applicant can choose from the following options- Three and half months, Six and half months, Nine and half months including 15 days waiting periods after which the policy coverage kicks in
    • Hassle-free Claims: Max Bupa health insurance provides in-house claim settlement and cashless claims processing in 30 minutes

    Eligibility Criteria to buy Corona Kavach Policy by Max Bupa Health Insurance

    Anyone can purchase this policy if they are minimum 18 years old and maximum 65 years old. Even if the proposer is older than 65 years, he/she can buy this coronavirus health insurance policy for their family members, including:

    • Spouse
    • Parents and in-laws
    • Dependent Children can also be insured till they are 25 years old. If the insured children is above 18 years and is independent, he/she shall not be allowed to get coverage under this Coronavirus health insurance plan

    Inclusions of Max Bupa Corona Kavach Policy

    Max Bupa health insurance will cover the hospitalization expenses incurred by the insured person on coronavirus treatment upon being diagnosed coronavirus positive as per the reports given by the diagnostic centre, which is government approved. The inclusions under this policy are given below:

    • Hospitalisation Coverage up to Rs 5 Lakh
    • It includes room rent, nursing and boarding charges to be paid to the hospital or a nursing home
    • It also pays for bills charged for treatment in an ICU and ICCU
    • Fees charged by a surgeon, treating doctor, anesthetist , consultant, and specialist
    • Anesthesia, operation theatre charges, surgical appliances, blood, ventilator charges, oxygen, medicines and drugs, diagnostic tests, masks, PPE Kits, and gloves
    • Road Ambulance cover is provided up to Rs 2,000
    • Transportation charges from one hospital to another, if required as a part of the treatment

    Pre hospitalization Expenses: Pre-hospitalisation medical expenses incurred on COVID treatment 15 days before hospitalisation are covered provided:

    • It is only related to coronavirus treatment
    • And the homecare treatment and hospitalization is admissible

    Post Hospitalization Expenses: Post-hospitalisation medical expenses incurred on COVID treatment 30 days before hospitalisation are covered provided:

    • It is only related to COVID-19 treatment
    • And the homecare treatment and hospitalization is admissible
    • Coverage of Pre-existing Diseases: It covers co-morbid conditions along with pre-existing diseases up to sum insured
    • Home Care Treatment Expenses: Medical expenses incurred on treatment taken at home for coronavirus as suggested by the doctor, provided daily monitoring chart is maintained as per the policy schedule
    • AYUSH Treatments Coverage: Ayush treatment expenses are also covered including Yoga, Ayurveda, Unani, Naturopathy, Homeopathy, and Siddha as specified in the policy schedule
    Add-on Cover
    • >Hospital Cash Benefit: The policy also offers option to get additional 0.5% of coverage amount as daily cash benefit for a maximum of 15 days

    Permanent Exclusions of Max Bupa Corona Kavach Policy

    The policy shall not cover the following medical expenses under any circumstances:

    • OPD and Day Care Treatment
    • Evaluation and Investigations
    • Rehabilitation, Rest Cure and respite care
    • Dietary supplements and vitamins unless prescribed under the treatment
    • Any coronavirus related claim before the policy commencement
    • Diagnosis or medical treatment outside India
    • Testing done at a non-government recognized Centre
    • Travel history to restricted countries

    Other Limitations

    Claims are rejected under the following conditions:

    • If the insured is found to be undergoing treatment in a medical facility or hospital that is not recognized by the concerned authorities
    • Treatment taken in a hospital or advised by a doctor who is not recognized by the Central Council of Indian Medicine/Medical Council of India/ Central council of Homeopathy or by the concerned authorities
    • Treatment provided by insured person immediate relative or family member or someone who lives in the same residence as the policyholder
    • Treatment received in a healthcare facility/nature care clinics or any other establishment that is not recognized

    Max Bupa Corona Kavach Policy Claim Procedure

    The claim procedure and turn-around time for corona kavach policy is given below:

    Type of Claim Prescribed Time Limit
    Reimbursement of Pre-hospitalization and hospitalization expenses Within 30 days of getting discharged from hospital
    Home Care Treatment reimbursement claim Within 30 days from completion of home care treatment
    Post hospitalization expense reimbursement claim Within 15 days of completion of post hospitalization treatment

    Here is the Claim Process:

    To initiate the claim process, the policyholder needs to send a notice to the insurer/TPA as mentioned under:

    • Within 24-hours of emergency hospitalization or cashless home care treatment
    • For planned hospitalization inform 48 hours before hospital admission
    • Submit all the documents when filing a claim and submit them within the prescribed time limit

    Documents Required for Max Bupa Corona Kavach Policy Claims

    In case of COVID hospitalizations following documents are required by the insurer:
    • Duly signed and filled claim form/li>
    • Payment receipts/li>
    • Original hospitals bills with expense break-up/li>
    • Copy of the passport of the insured patient ( if available)/li>
    • Photo Identity proof of the patient (in case passport is not available)/li>
    • Doctor’s prescription advising hospital admission/li>
    • Hospital discharge summary with patient’s medical history and other details/li>
    • Investigation reports including medical test reports from Authorized COVID diagnostic Centre/li>
    • Operation theatre’s notes and Surgeon’s certificate with operation details ( wherever applicable)/li>
    • KYC details for claims above Rs 1 Lakh/li>
    • NEFT details for claim settlement and a cancelled bank cheque/li>
    • Legal heir certificate, as applicable/li>
    • Any other documents are required by the TPA/Insurance Company

    For homecare treatment following documents are required:

    • Claim form ( duly filled and signed)
    • Passport copy of the patient ( all pages) passport, if available (All Pages)
    • Photo ID Proof (in case passport is not available)
    • Medical practitioner’s prescription advising home care treatment
    • Discharge Certificate from doctor mentioning date of start and completion of home care treatment
    • Daily monitoring chart to be maintained with medical records of treatment and is singed by the treating doctor

    Max Bupa Corona Kavach Policy FAQs

    • Q1. Should I buy corona kavach policy from Max Bupa health insurance?

      Ans: Max Bupa Corona Kavach Policy is a relatively affordable health insurance policy that people up to the age of 65 years can buy for self and their immediate family members. COVID-19 is not showing signs of stopping soon and while we continue to fight this pandemic, we also need to ensure medical security. With a Corona Kavach health insurance policy, you can your family can enjoy peace of mind without worrying about expenses related to coronavirus treatment.

    • Q2. What is the coverage amount available in corona kavach plan?

      Ans: Corona Kavach is a coronavirus health insurance plan that offers a minimum coverage amount of Rs 50,000 and a maximum of Rs 5 Lakh. The coverage is offered on both family floater and individual basis. In a family floater plan the sum insured will apply to all the family members, however, if you buy it on individual basis, the sum insured will apply to every member individually, and the premium will be on a higher side.

    • Q3. Are pre-existing illnesses included under corona kavach plan?

      Ans: Yes, Max Corona Kavach plan covers pre-existing medical conditions including co-morbidities along with COVID-19 treatment up to the limit of coverage amount.

    • Q4. Is home care treatment covered in corona kavach policy by Max Bupa health insurance company?

      Ans: If the treating doctor or medical facility suggest coronavirus treatment at home, then Max Bupa corona kavach policy will cover the cost of home care treatment for Coronavirus on positive diagnosis in a diagnostic Centre that is a by the government. Coverage is provided for maximum 14 days subject to policy terms and conditions.

    • Q5. Is Ayush treatment covered in every hospital in Max Bupa Corona Kavach Plan?

      Ans: To get coverage benefits, there are certain guidelines when it comes to availing Ayush treatment cover including Ayurveda, Unani, Homeopathy, Siddha, and Naturopathy. Only the following Ayush hospitals are considered to be eligible for claim:

      • Ayush hospital registered with the State or Central Government
      • Teaching hospital attached to AYUSH College recognized by the Central Council of Indian Medicine/ Central Council for Homeopathy
      • AYUSH Hospitals registered with the local authorities, and fulfilling the following criterion:
      • Medical facility to have a minimum of 5 in-patient beds
      • Maintaining patient’s medical records daily and making them accessible to the authorized representative of the insurance company
      • Medical facility should have AYUSH doctors in charge 24*7
      • Medical facility to be equipped with dedicated AYUSH therapy sections and operation theatre to carry out surgical procedures as required

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