IRDA has ordered that every health insurance policy should cover the hospitalization costs incurred due to Coronavirus and settle the claim as per the terms and conditions. This has led to the creation of separate health insurance covering Coronavirus with the sum insured and all the other coverage being constant across the insurance companies. IRDA has asked the insurance companies to launch the Corona health insurance which is standardized across the insurers. Corona Kavach and Corona Rakshak health insurance policies are launched by the insurance companies to cater to the corona claims.
Table of Contents:
What is Corona Health Insurance?
Coronavirus Health Insurance refers to an insurance policy that covers the medical expenses incurred in the treatment of COVID-19. A coronavirus health insurance policy is designed to cover hospitalization expenses of the policyholder, irrespective of the disease that he has been diagnosed with (unless it is a critical illness that is not covered).
Almost all cover hospitalization expenses incurred in the treatment of viral infections. Since Coronavirus is a viral infection, a comprehensive health insurance policy pays off pre & post-hospitalization expenses including in-patient and out-patient expenses, incurred during the treatment of COVID-19.
Difference between Corona Health Insurance and Standard Health Insurance?
||Corona health insurance
||Standard Health Insurance
||The cover under corona health insurance is limited to treatment for Corona only.
||The coverage under standard health insurance policies includes all kinds of illnesses and diseases. The treatment undertaken for Coronavirus is also covered under your standard health insurance policy.
|| The policy term in Corona health insurance is 3.5 months, 6.5 months, and 9.5 months.
||The policy term in a standard health insurance policy is 12 months.
||The corona rakshak policy exhausts once the claim is paid under the policy as it is a benefit-based policy.
||In standard health insurance, you can claim any number of times in a policy year subject to the maximum limit of the sum insured.
||The premium for Corona health insurance policies is only 1/4rth of the standard health insurance policies.
||The standard health insurance policies are costlier compared to the corona-specific health insurance policies due to the wide range of cover offered under standard health insurance policies.
||Tax benefits cannot be claimed under any Corona health insurance policy
||Tax benefits can be claimed under Section 80D for standard health insurance policy up to Rs.25, 000. Even the premium paid for senior citizens can also be claimed under the Income tax act.
||The claim is settled on a Cashless as well as reimbursement basis.
||The claim is settled on a cashless and reimbursement basis as per the choice of the customer.
||The maximum sum insured in Corona health insurance policies is Rs.5 Lac. If needed more than this, then the customer has to take additional policies on payment of additional premium.
||There is no limit for the maximum sum insured under the standard health insurance policy as the maximum sum insured depends on the underwriting decision of the insurance company.
||The premium is to be paid in a lump sum or at one time only.
||The premium under a standard health insurance policy can be paid in installments.
|Pre Existing Disease
||The pre-existing diseases related to Corona are not covered under the Corona-specific health insurance policies.
||The pre-existing diseases are covered after a waiting period of at least 2 years from the policy start date.
|Initial waiting period
||The initial waiting period of 15 days is applicable on every corona insurance policy.
||An initial waiting period of 30 days is to be satisfied on every standard health insurance policy.
||A minimum of 24 hours to 72 hours of hospitalization is mandatory for Corona health insurance.
||A minimum of 24 hours of hospitalization is mandatory under the standard health insurance policy.
||The sum insured cannot be enhanced midterm. Sum insured enhancement can be done only at the time of renewal.
||Midterm sum insured enhancement is permitted subject to satisfactory underwriting.
|Day Care & OPD
||Daycare &OPD treatments are not covered under Corona health insurance policies.
||Daycare & OPD are covered under standard health insurance policy subject to the terms and conditions.
||No ICU limit is set on the corona health insurance policies.
||ICU limits are set under the standard health insurance policies. Generally, the ICU charges are limited to 1% to 5% of the sum insured selected by the insured.
||Only daily cash benefit is available as an add-on under the corona health insurance policy on payment of extra premium.
||There are many add-ons available under the standard health insurance plan such as Critical illness, Daily cash, etc. which can be availed on payment of an extra premium.
Is it necessary to have Corona specific health insurance policy if I have an Individual health insurance policy?
The main difference between a regular health insurance policy and a Corona health insurance policy is that the former covers any kind of illness or disease while the latter covers only Corona-related treatments. Corona health insurance policy is designed keeping in mind the need for a health insurance policy to combat the Coronavirus pandemic at a low premium compared to the general health insurance policies.
There might be a doubt about whether it is necessary to take a Corona health insurance policy after having a general health insurance policy, but the main point to be noted here is that the Corona health insurance policy would survive in the market only till the time pandemic exists. Once the Coronavirus pandemic is driven from the country then there would be no need for specific Corona health insurance policies.
IRDA has created a Corona health insurance policy for the following reasons:-
- To cover the costs of Corona treatment at a low cost. There were many people in India without health insurance in India and this product is intended to cover them against the pandemic and the treatment costs arising out of it.
- To increase the health insurance penetration in India with this product thereby saving millions of Indians from getting bankrupt.
- To make health insurance affordable to the rural masses and bring a benefit-based health insurance policy into the market.
The Corona health insurance policy can be taken as an addition to the Standard health insurance policy for the below reasons:-
- Standard health insurance policy provides you with an increased sum insured every claim-free year in the form of a claim bonus which is not available in the Corona health insurance policy. In case of any claim under your standard health insurance policy, the renewal premium may go up and at the same time the No claim bonus would not be made available for that particular year.
- The premium of a Corona health insurance policy would not even be 1/4rth of the premium of your standard health insurance policy. This way the increase in renewal premium (due to claims) would be more than the Corona health insurance premium.
- The standard health insurance policy can be used as a buffer in case the sum insured in the Corona health insurance policy exhausts. Since the premium won’t be increased if there is a claim under the Corona insurance policy, it is advisable to take a Corona health insurance policy along with the Standard health insurance policy.
Employer Health Insurance or Corona-Specific Insurance?
The Employer or Group health insurance policy covers the employee and/or his/her family where the premium payment is made by the employer in most cases while the Corona-specific health insurance policy should be purchased by individuals paying premium from their pockets. Employer health insurance is also known as a Group health insurance policy where there would be no concept of no claim bonus at the time of renewal. The premium is paid by the employer and the claim is settled by the employee by the insurance company.
It is important to have a Corona-specific health insurance policy even though there is an employer health insurance policy due to the below reasons:-
- The unemployment rate is increasing drastically in the country due to the lockdown imposed as a result of the increasing Corona cases. There is no job guarantee in many fields and if you lose your job suddenly, you’ll find yourself in a position without a health insurance policy.
- Employer health insurance is valid only till the time you are working in the organization, once you are out of the organization you would be in a situation where there would be no health insurance.
- Even if you take health insurance immediately after losing your job, there would be waiting periods till the actual coverage kicks in. In case you have suffered from Corona or any illness by taking the health insurance policy, then the waiting period would be at least 2 years as it comes under the pre-existing disease waiting period clause.
Top 5 Best Corona Health Insurance Plans in India
||Claim Settlement Ratio
|Star Health Insurance
||Star Novel Coronavirus Health Insurance Policy
|ICICI Lombard Health Insurance
||ICICI Lombard Health Insurance Covid-19 Protection Cover
|Future Generali Health Insurance
||Future Generali Health Total Vital Plan
|Raheja QBE Health Insurance
||Raheja QBE Arogya Sanjeevani Plan
|Niva Bupa Health Insurance
||Niva Bupa Health Companion Plan
Factors to Consider Before Purchasing a Corona Insurance Policy
Corona health insurance policies such as Kavach and Rakshak are designed by the IRDA to be sold by the insurance companies to the general public keeping in mind the ongoing Corona situation in the country. These policies have standard wordings among all the insurance companies but the premiums are decided by the insurance companies keeping in mind different factors such as loss ratio, expenses, etc. The actuarial team of each insurance company designs the product with the terms and conditions specified by the IRDA and finalizes the premium rates. The premium rates might differ from one company to the other and so does the quality of service.
- Insurance Company:
Corona Kavach Policy should be sold mandatorily by all the insurance companies while the Corona Rakshak is optional to the insurance companies. It is important to check the insurance company before purchasing the corona health insurance policy as the service levels differ from one insurance company to the other. Most of the insurance companies are already facing huge loss ratios in the health segment due to the high number of corona-related claims which are being settled by the insurance companies.
- Premium Amount:
The premium amount for Corona health insurance policies would be decided by the actuarial team of the respective insurance company based on different factors such as future loss ratio, service levels, and other expenses. The cheapest insurance company cannot always be the best claim settlement company.
- Policy period:
Corona Rakshak and Kavach insurance policies are available in three policy periods; 3.5 months, 6.5 months, and 9.5 months. The policy period should be decided by the insured customer. The policy can be renewed by the customer by selecting the policy period at the time of renewal.
- Network Hospitals:
Network hospitals are hospitals that offer cashless treatment to the customers of a particular insurance company. The network hospitals are also cashless hospitals where the insurance companies agree to settle the claims of their customers cashless.
- Claim Settlement Ratio:
The claim settlement ratio is the number of claims settled by an insurance company to the total number of claims received during a period. The average claim settlement ratio should be more than 95% which means that there are greater chances of your claim getting settled. The claim settlement ratio alone cannot be taken into consideration before deciding on the insurance company. Claim settlement amount should also be considered by the customers.
Intermediaries play an important role in the distribution and service of insurance policies. The impression of an insurance company can be created or destroyed mostly by the intermediaries as these are the ones who offer the services to the customers on behalf of the insurance companies.
Corona Health Insurance Exclusions
Corona health insurance policies such as Kavach and Rakshak have certain exclusions under them which are listed below:-
- Treatment or Diagnosis outside India: The policy doesn’t cover the treatment costs for Coronavirus outside India. In case the corona infection is spread when you are outside India, then the coverage is not applicable in that case as the diagnosis is done outside India. The policy covers only the diagnosis and treatment in India and the claim is made as per the treatment done.
- Hospitalization: The corona health insurance policies require a mandatory hospitalization of 24 hours to 72 hours for the Kavach and Rakshak, without which the claim is not admissible under the policy. In the case of domiciliary treatment, the claim is not admissible unless the hospitalization condition is satisfied. The main thing to note is that all the Corona infection cases are not serious and most of the cases are treated at home.
- Other Illness: Any other illnesses or diseases not related to Corona are not covered under your Corona health insurance policies. The claim is admissible for the corona-related illness treatment which requires mandatory hospitalization. Since the policy covers only Corona-related illnesses, the premium charged for this policy is very less compared to the standard health insurance policy.
- Waiting Period: Any claim reported before the waiting period is not covered under the corona health insurance policy. The waiting period under the corona health insurance policies is 15 days from the policy start date. The waiting period is not applicable if the insurance policy is renewed on time without any break in the policy period.
- Renewals: There is no chance for renewal under the Corona rakshak policy and a new policy is to be purchased after the expiry of the previous policy. The renewals are possible in case of Kavach policies are permitted and the waiting period is waived off in such cases.
- Portability: Portability is permitted only for the Corona Kavach insurance policy subject to the new insurance company accepting the policy. The portability is easy for the Kavach policy as the terms and conditions are the same for every insurance company and only the premium differs from one company to the other.
- Diagnosis: The diagnosis for Corona should be done at a Government recognized test center only and the report should be submitted to the insurance company to process the claim. Any diagnosis report from unrecognized centers would not be acceptable to the insurance companies.
- OPD & Day Care: OPD and Daycare are not available in the Corona health insurance policies as these policies require mandatory hospitalization of at least 24 hours in a recognized hospital as per the definition mentioned in the policy wordings.
For the best Corona health insurance policies please visit the health insurance page on the PolicyBachat website or talk to our agent to choose the best corona insurance policy.