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All You Need to Know About Health Insurance & Coronavirus

Coronavirus has infected hundreds of people all over the globe and in India. It has also caused the death of several people.

Under these present circumstances, it is important to know whether coronavirus is covered in your health insurance plan and how you can protect yourself financially.   

Is coronavirus covered in my health insurance plan?

Instead of stressing over the question, you can find that out by reading the policy document and contacting your health insurance provider.  

Most of the health insurance policies cover epidemics/pandemics such coronavirus. Only a handful of policies have clauses that exclude epidemics and pandemics.

However, there are high chances of your claims getting proceeded as the Insurance Regulatory and Development Authority of India(IRDAI), the insurance regulator, has said that claims reported under Covid-19 should be reviewed thoroughly before rejecting any claim.

Coronavirus will also be covered under the government’s Ayushman Bharat scheme that provides a basic Rs 5-lakh cover. It will cover the treatment of the disease.

What aspects will be covered in health insurance?

As COVID-19 is a new disease it will come under the list of pre-existing disease but will be covered under your base health insurance policy. If you have travelled from a coronavirus affected country and diagnosed positive, you are most likely to be covered under the policy if you are being quarantined in India.

Most policies will cover hospitalisation charges like any other diseases and a standard waiting period of 30 days may be applicable. In most of these policies, the severity of the disease and the travel history or family history of the person will have no impact on the policy. Health insurance claim due to coronavirus will be paid if you are hospitalised for at least 24 hours. But, if you are not hospitalised, then your policy may not cover the claim.  

Other than hospitalisation charges, health insurance policies may also cover post-hospitalisation expenses after one is discharged from the hospital.

A few insurance providers have also extent hospitalisation coverage to quarantined individuals who may not even be diagnosed positive.

How to claim health insurance for Coronavirus

Reimbursement and cashless are two ways to file for a health insurance claim.

The hospital claims are cashless if the treatment takes place in a network hospital. In this case, you are not required to make the payment and then file for reimbursement. Most health insurers provide cashless treatment to their policyholders.

However, if you undergo treatment in a non-network hospital, you have to pay the entire treatment cost upfront and later fill the reimbursement form.   

Cases where your claims can get rejected 

 If you are not hospitalised for at least 24 hours

As coronavirus is covered under your base health insurance policy as any other illness, your claims may get rejected if you are not hospitalised for at least 24 hours.  

If epidemic/pandemic are excluded from your policy 

Your claim can get rejected if your insurer has excluded epidemic and pandemic diseases.    

If you get coronavirus within the waiting period 

Health insurance policy has a fixed standard waiting time that starts from the day you purchase the policy. If you raise your claim within the waiting period, there are higher chances of your claims getting rejected.

If you or your family member have been from an affected country

While the above-mentioned condition will be covered under regular insurance plans, coronavirus specific insurance policies may not cover it and it may lead rejection of your claim.   

Coronavirus specific health insurance plans 

Looking at the severity of coronavirus, few insurers have introduced coronavirus specific insurance plans. In case you don’t have a health insurance policy and you are worried about coronavirus, you can look at these plans.

Star Novel Coronavirus 

Star Novel Coronavirus (nCoV) (COVID-19) Insurance Policy is the coronavirus oriented health insurance policy by Star Health and Allied Insurance that gives insurance coverage for treatment of coronavirus disease.  

If you buy the policy, you can get the sum insured if you test positive and needs hospitalisation for coronavirus treatments after 16 days. The maximum sum assured of the plan is Rs.42,000. You have two sum insured options of Rs. 21,000 and Rs 42,000 that you can avail by paying a premium of Rs. 459 and Rs. 918 with taxes respectively.

This insurance policy will also cover individuals who have undertaken international travel and is available for individuals under 65 years of age without any medical screening.

You can buy this policy online through the Star Health website or any insurance agent.

Digit Health Care Plus

Digit Insurance has launched a health insurance plan – Health Care Plus Policy that will cover an individual against the coronavirus disease. It will offer financial assistance to individuals who are tested positive and quarantined. It offers insurance cover from Rs.25,000 to Rs.2 lakh.

The insurer will pay 100% of the cover for positive cases and 50% of the sum insured for quarantined cases. 

However, the policy comes with a lot of conditions. E.g. to become eligible for the policy, you should not come in contact with an individual with a suspected history of the coronavirus disease until the policy ends.

Moreover, the insured or immediate family members should not have travelled to China, Japan, Singapore, Thailand, Malaysia, Hong Kong, Macau, Italy, Iran, Bahrain, Kuwait and Taiwan since December 1, 2019, and should not be suffering from symptoms such as cough with or without sputum, cold/nasal block, fever with body pain or shortness of breath for the last six weeks, as these may be symptoms of the disease already contracted.

Clinikk Healthcare

Clinikk Healthcare has launched an insurance product to cover the Coronavirus disease. This product will help individuals with coronavirus infection to undergo treatments for themselves and families.

The premium paid for the product is affordable at Rs. 499/year.  

Conclusion: 

In this article, we have seen that there is nothing much to worry if you have health insurance. However, it is better to check with your insurer for any exclusion for pandemic diseases. Coronavirus will be covered in your policy base and not as a separate disease. However, if you have taken a health insurance policy in the last few days, your claim may be rejected if you are still under the waiting period.

Hence, having a health insurance policy is important as it can offer financial assistance during any emergency period. While having health insurance is essential, it is equally important to have an emergency fund to take care of such medical emergencies.


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