Coronavirus: Will your health insurance cover a pandemic?

With the coronavirus outbreak (Covid-19) spreading rapidly across the world, the World Health Organisation (WHO) has declared it a global pandemic, an illness that has spread far and wide.

Over the past two weeks, the number of cases outside China has increased thirteen-fold and the number of affected countries has tripled, said WHO Director-General Tedros Adhanom Ghebreyesus at a press conference in Geneva.

In India, the number of cases reported under Covid-19 by the Union Health Ministry is 60 (as of March 11), with the highest number of cases in Kerela.

There is worry now over the costs of medical treatment and hospitalisation, and whether health insurance will cover it. Last week, the Insurance Regulatory and Development Authority of India (IRDAI) issued a circular saying insurers who cover coronavirus under their policies should ensure that the claims are handled expeditiously and costs are settled per applicable norms.

The regulator also emphasised that insurers shall review the claims thoroughly before repudiating them. However, one is not sure if insurers will cover claims under Covid-19 now that it has been termed a pandemic.

The pandemic problem

Since the beginning of this month, even as IRDAI came up with its circular on fast-tracking Covid settlements, health insurers including SBI General, Edelweiss General and Cigna Manipal have been stating they will do the needful for their policyholders, covering expenses for the treatment as well as those incurred during the quarantine period up to the sum insured.

However, the pandemic angle may again change the equation. If the number of Covid cases and deaths rise, insurance companies may take a step back.

Speaking to health insurers revealed that most are yet to take a call post WHO’s pandemic announcement. When the cases increase, the cost of tests and treatment will also rise, and insurance companies may not be in a position to service them all without landing themselves in losses.

New-age health insurers, however, may be more willing to cover Covid patients in an attempt to capture the market. Digit Insurance, for instance, is covering the disease.

In the beginning of this month, Digit launched a product for Covid-19 that covers both positive and quarantined cases, offering coverage from ₹25,000 to ₹2 lakh. The company has said it will not exclude cover for Covid or any other pandemic under its existing health product (Digit Health Care Plus) or it new Covid product.

Read the conditions

However, note that while Digit will pay 100 per cent for positive cases, it will offer only 50 per cent of the sum insured for quarantined cases. Also, the exclusions require a careful read. The policy states that for being eligible, the insured should not have been in contact with someone with a suspected history of the coronavirus disease till the policy ends.

Also, the insured or their immediate family members should not have travelled to China, Japan, Singapore, Thailand, Malaysia, Hong Kong, Macau, Italy, Iran, Behrain, Kuwait and Taiwan since December 1, 2019. They 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.

Now, that’s a lot of ifs and buts for anyone looking for a Covid cover.

So, it is suggested that you be prepared to handle the situation, if it arises, with some ready cash in hand. If your insurer doesn’t cover it, you should be in a position to fund it from your pocket.

SBI General Insurance, Edelweiss General Insurance and Bajaj Allianz General confirmed to BusinessLine   they will cover expenses against the treatment of Covid though it has turned a pandemic.

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