FAQs about coronavirus insurance settlement

Read on to clear all your doubts about the Corona Kavach insurance plan.

FAQs about coronavirus insurance settlement

The year 2020 has been a year of uncertainty and urgency all over the world. The COVID-19 pandemic, which started early in the year is still at large, and treatment and prevention remain speculative subjects. But the same ambiguity should not plague your health insurance plan. With the threat of the novel coronavirus finding a place in our daily lives, insurers in India have introduced the Corona Kavach plan in all their insurance policies. However, its features and benefits are still unclear, causing some confusion among health insurance policyholders. 

Related: Are unprecedented pandemics covered under health insurance?

Here are some commonly asked questions regarding coronavirus insurance and their answers.

1. Do all health insurance plans include COVID-19 coverage?

A lot of people are still unsure if their existing health insurance plan covers the treatment of coronavirus or if they are required to buy an additional policy specifically for its coverage. The good news is that the Insurance Regulatory and Development Authority of India (IRDAI) has mandated that all standard health insurance plans should cover the costs of coronavirus treatment in the country. The regulatory authority also issued a guideline for insurance companies to carefully review all claims and be careful of rejecting coronavirus claims. So, you can depend on your existing health insurance plan for coronavirus coverage.

2. Does home quarantine qualify for an insurance claim?

This could differ on a case-to-case basis as the rules can vary according to the insurance company. Most insurance companies require hospitalisation for at least one day (24 hours) to approve the claim process. However, some insurance providers could provide cover depending on factors such as the availability of hospital beds in the area. These provisions should be confirmed with your insurance company in advance.

3. Would a regular insurance plan cover the increased room rent?

With a scarcity of beds in hospitals due to the increasing number of coronavirus affected patients, many hospitals have increased room rents. Although the General Insurance Council (GIC) had recommended a cost structure that every hospital can follow depending on the type of hospital and the effect of the illness, not all hospitals have agreed to follow this structure. Many still follow their own pricing arrangements.

Typically, insurance policies offer room rent coverage of 1%–2% of the entire sum assured. So, if your sum assured is Rs 1,00,000, you can claim room rent of up to Rs 2,000 depending on your insurance plan. Anything beyond this amount is usually borne by the policyholder, except for admission to the ICU. The Corona Kavach policy has no room rent capping clause, but insurers might use local regulations and GIC guidance to settle claims. 

4. Is the Corona Kavach policy good enough?

The Corona Kavach policy was introduced as a way to help people manage the costs of treatment of COVID-19, but the question of whether it is enough is a moot one. Firstly, the policy offers variants that cover you for 3.5 months, 6.5 months, and 9.5 months. So, if you buy a policy for 3.5 months, you might need to buy a new one after this period if there is no treatment available by then. 

There is no provision to renew the plan. This can be a reason to worry because buying a new plan will result in a 15-day waiting period, meaning you will not be covered for this duration. Moreover, the policy is only valid till 31 March 2021. Coverage for the policy ranges from Rs 50,000 to Rs 5 lakh, and it’s best to choose one based on factors such as pre-existing conditions and frequency of travel. 

Related: Insurance cover for COVID-19 in India

5. How smooth is the coronavirus claim settlement process?

Most coronavirus insurance covers follow the same settlement process as any other ailment. If your insurance provider offers cashless hospitalisation, you can avail of the facility. But the process can differ in some dire situations. Given the shortage of beds, you may not find a COVID-19 ward or bed in a network hospital and may have to go to a different one. In such a case, you may have to opt for the reimbursement model. Therefore, it helps to be certain of the hospitals in the network covered by your insurance company to avoid any last-minute hassles.

Related: COVID-19: Some frequently asked questions

Last words

While some inconsistencies still exist in the system due to the newness of the plan, a lot has been done to ensure that patients get the care they need without having to worry about the costs. However, to be entirely sure of what your policy entails, it is advisable to have a clear and open conversation with your insurance provider. This will eliminate the chances of any unexpected issues at a time when all you should focus on is your health.

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