IRDA has came out with guidelines with respect to Corona Kavach Policy.
This policy is called a Corona Kavach Policy. Let us see the features and benefits of it in detail
In view of the global pandemic Covid 19, IRDA has decided to mandate all general and health insurers to offer Individual Covid Standard Health Policy with the following objectives-
- To have a Covid specific product addressing basic health insurance needs of insuring public related to Covid.
- To have a standard product with common policy wordings across the industry.
Features & Benefits
Tenure of the Policy:
The policy period is 3 and half months, 6 and half months, and 9 and half months (including the waiting period). Hence it is always less than a year (which is the standard norm for all other health insurance products. Here, as it is a disease-specific, it is less than a year period.
Cost:
Even though the product features are same across all insurers, the price vary based on the company to company. Hence, you have to check with individual companies before buying a product.
Coverage:
The minimum coverage is Rs.50,000 and maximum cover is Rs.5,00,000
Entry Age:
The minimum age is 18 years and maximum entry age is 65 years. However, Dependent Child / children shall be covered from Day 1 of age to 25 years subject to the definition of ‘Family’
Premium Payment:
Only single premium payment option is available as it is limited for less than a year
Individual Plan / Family Floater:
This plan is available individually or as a family floater. Hence, it is acting like a typical health insurance product with this feature. Here, family means-Self, Spouse, parents and parents-in-law, and dependent Children (i.e. natural or legally adopted) between day 1 of age to 25 years
Main Product Features:
Base Cover:
The hospitalization expenses incurred by the insured person for the treatment of Covid on Positive diagnosis of Covid in a Government Authorized Diagnostic Center. The coverages are as below.
- Room, Boarding, Nursing Expenses as provided by the hospital or nursing home.
- Surgeon, Anesthetist, Medical practitioner, Consultant, special fees whether paid directly to the treating doctor or to the hospital.
- Anesthesia, Blood, Oxygen, Operation theater charges, surgical expenses, ventilator charges, medicines and drugs, costs towards diagnostic, PPE kit, gloves, mask, and such other expenses.
- ICU or ICCU expenses.
- Ambulance expenses to the maximum of Rs.2,000 per hospitalization.
Home Care Treatment Expenses:
It will cover the costs of treatment of Covid incurred person on availing treatment at home maximum up to 14 days per incident provided that:-
- The medical practioner advices the insured person to undergo treatment at home.
- Continues active treatment and daily monitoring expenses.
- Cashless home care benefit is available.
- If the insured willing to take the service from non-network hospitals, a prior approval is required. Insurance company will respond to the same within 2 hours of receiving the request.
- The expenses covered are: Diagnostic test undergone at home or at the diagnostic center, medicines prescribed in writing, consultation charges, nursing charges, medical procedure expenses or cost of a pulse oximeter, oxygen cylinder and Nebulizer.
Ayush Treatment is covered
Pre Hospitalisation:
Medical expenses incurred with respect to Covid prior to 15 days of hospitalization are also covered.
Post Hospitalisation:
Medical expenses incurred after the discharge of up to 30 days is also covered under this insurance.
Deductible:
There is no Deductible in this Policy.
Optional Cover:
Hospital Daily Cash:
The company will pay 0.5% of sum insured per day for which 24 hours of continuous hospitalization for treatment of Covid following an admissible hospitalization claim under this policy. This benefit will be payable for up to the maximum of 15 days during the policy period.
Waiting Period:
There is a waiting period of 15 days from the date of policy issued. The Company shall not be liable to make any payment under the policy in connection with or in respect of expenses till the expiry of waiting period.
Exclusions:
- Expenses related to any admission primarily for diagnostics and evaluation purposes. Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment.
- Rest, Cure & Rehabilitation.
- Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a medical practitioner as part of hospitalization claim or Home care treatment.
- Expenses related to any unproven treatment, services and supplies for or in connection with any treatment. Unproven treatments are treatments, procedures or supplies that lack significant medical documentation to support their effectiveness.
- Any claim in relation to Covid where it has been diagnosed prior to Policy Start Date.
- Any expenses incurred on Day Care treatment and OPD treatment.
- Diagnosis /Treatment outside the geographical limits of India.
- Testing done at a Diagnostic center which is not authorized by the Government shall not be recognized under this Policy.
- All covers under this Policy shall cease if the Insured Person travels to any country placed under travel restriction by the Government of India.
Bottom Line:
If someone is willing to buy the health insurance immediately with the fear of corona virus, then this policy may be suitable to you.
Individuals with Existing Health Cover
Those who are having health insurance may no need to buy this policy. Instead, they can enhance the cover either in the base plan or buy a super top-up plan.
Artharthi 