IRDA came out with guidelines with respect to Covid Standard Health Policy or Corona Kavach Policy – Features and Benefits. This policy is called a Corona Kavach Policy. Let us see the features and benefits of Coronavirus or Covid Standard Health Policy in detail. This product is available before 10th July 2020.
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.
All General Insurance companies wil start to offer this standalone individual special health insurance for the public.
Covid Standard Health Policy or Corona Kavach Policy – Features and Benefits
Let us now look into certain features of this Corona Kavach Policy in details.
What is the tenure of Corona Kavach 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.
How much it will 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.
How much is the coverage?
There are two covers here. One is base cover and the second is optional cover.
1) Covid Hospitalization Expenses:-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.
a) Room, Boarding, Nursing Expenses as provided by the hospital or nursing home.
b) Surgeon, Anesthetist, Medical practitioner, Consultant, special fees (including the telemedicine) whether paid directly to the treating doctor or to the hospital.
c) Anesthesia, Blood, Oxygen, Operation theater charges, surgical expenses, ventilator charges, medicines and drugs, costs towards diagnostic, PPE kit, gloves, mask, and such other expenses.
d) ICU or ICCU expenses.
e) Ambulance expenses to the maximum of Rs.2,000 per hospitalization.
2) Home Care Treatment Expenses:-Health insurance will cover the costs of treatment of Covid incurred person on availing treatment at home maximum up to 14 days per incident provided that:-
a) The medical practioner advices the insured person to undergo treatment at home.
b) Continues active treatment and daily monitoring expenses.
c) Cashless home care benefit is available.
d) However, 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.
e) 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.
3) Ayush Treatment
4) Pre-Hospitalization-Medical expenses incurred with respect to Covid prior to 15 days of hospitalization are also covered.
5) Post-Hospitalization-Medical expenses incurred after the discharge of up to 30 days is also covered under this insurance.
6) There is NO DEDUCTIBLE in this policy.
Hospital daily cash-The company will pay 0.5% of sum insured per day for which 24 hours of continues 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.
Whether individual or 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, legally wedded spouse, parents and parents-in-law, and dependent Children (i.e. natural or legally adopted) between day 1 of age to 25 years. If the child above 18 years of age is financially independent, he or she shall be ineligible for coverage.
How much cover you can opt for?
The minimum coverage is Rs.50,000 and maximum cover is Rs.5,00,000.
What are the premium payment options available?
Only single premium payment option is available as it is limited for less than a year insurance.
What is the minimum and maximum 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’.
Is it availble for lifelong renewable?
Lifelong renewability, migration and portability stipulated under Regulation 13 and 17 of IRDA (Health Insurance) Regulations, 2016 respectively are not applicable.
Is there any waiting period?
Yes, 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.
What are the exclusions?
Below are the 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 and respite care
# 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. However, treatment authorized by the government for the treatment of COVID shall be covered.
# 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.
Whether multiple policies allowed?
Yes, as you know this policy covers the maximum of Rs.5 lakh sum insured, one can buy multiple policies and cover the expenses beyond Rs.5 lakh.
If the amount to be claimed exceeds the sum insured under a single policy, the policyholder shall have the right to choose insurers from whom he/she wants to claim the balance amount.
Where an insured has policies from more than one insurer to cover the same risk on indemnity basis, the insured shall only be indemnified the hospitalization costs in accordance with the terms and conditions of the chosen policy.
Let me tabulate the whole features for your better understanding.
Covid Standard Health Policy or Corona Kavach Policy – Should you buy?
As IRDA earlier itself cleared the doubts that all your existing health insurance policies covering the Corona virus-related hospitalization, those who are having health insurance may no need to buy this policy. Instead, they may enhance the cover either in the base plan or buying a super top-up plan. (Refer oust posts:-Top 5 Best Health Insurance Plans in India 2020 and Top Up Health Insurance Plan & Super Top Health Insurance Plan-What are they?).
However, if someone is willing to buy the health insurance immediately with the fear of corona virus, then this policy may be suitable to you.
Covid Standard Health Policy or Corona Kavach Policy covers only the health issues related to corona, the premium will be much cheaper than the exhaustive health insurance products. Hence, it may be affordable to many.
The only hurdle is the maximum sum insured cap which is set at Rs.5 lakh. Considering the charges quoted by private hospitals, I don’t think Rs.5 lakh is sufficient for a family. Hence, you have to buy multiple health insurance to cover yourself from corona related hospitalizations.
The second hindrance is maximum entry age. It is set at 65 years. Hence, those who are above 65 years have no option but to buy a regular health insurance than this product.
As usual, pricing is left with insurance companies. Hence, let us see how much price variation for the same product 🙂
As per me, if the family consists of around 3-4 persons, buying around Rs.15 lakh to Rs.20 lakh coverage is a must.
Conclusion:-Considering the way Corona virus is spreading and affecting our life and finance, IRDA launched this unique product. If you have enough health insurance, then no need to worry. However, if you don’t have, then better to buy this product immediately. As this health insurance covers in-laws also, it is best to buy for them.
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