The outbreak of Covid-19 pandemic has highlighted the importance of health insurance across all ages of the population in the country. To provide access to health insurance for all, especially at this time of financial distress due to the coronavirus pandemic, the insurance regulator IRDAI, recently mandated all general and standalone health insurers to offer standard health policy for corona to be known as Corona Kavach Policy. Further, the regulator has asked insurers also to offer a standard benefit policy as well for Covid-19, to be known as Corona Rakshak Policy. Both policies are to be offered as standard policies, as per IRDAI requirements, which means, the coverages and exclusions across insurers (offering this product) will be the same, including the policy name.

Today, July 10, being the deadline for launch of these policies, you could see announcements coming from players. Here is what you should know about the two standard Covid-19 policies and whether or not you should buy one.

Basics

Both products, per guidelines, are to provide coverages only for treatment related to Covid-19. While Corona Kavach Policy is an indemnity plan (where the insurer reimburses/pays for medical expenses up to the sum insured (SI)), Corona Rakshak Policy is a benefit policy, wherein the insurer pays a lump-sum guaranteed amount up to the sum insured. This lump-sum benefit is payable upon the positive Covid diagnosis, requiring hospitalisation for a minimum continuous period of 72 hours. Do note that, the benefits under both policies shall be provided by the insurers after positive diagnosis of Covid from a Government authorised diagnostic centre.

While the Corona Kavach policy can be offered both on individual and family floater basis, Corona Rakshak is offered only on individual basis. Both policies can be availed for a period of 105 days (3.5 months), 195 days (6.5 months) and 285 days (9.5 months) and can be renewed in the same frequency to ensure the benefit of the policy continues.

The minimum SI under both policies is ₹50,000; however, the maximum SI offered under Corona Kavach is ₹5 lakh and for Corona Rakshak ₹2.5 lakh. The minimum and maximum age of entry is 18 and 65 years respectively, and only single premium payment mode is allowed under both policies. The Corona Kavach policy also offers cashless facility to its policyholders, provided hospitalisation is from network hospitals. Purchase of both policies can be made from across all distribution channels digital or through agents.

What’s covered?

As Corona Kavach is an indemnity policy, it covers both hospitalisation and homecare treatment expenses, up to the SI. However, the policy will cover hospitalisation expenses only if the policyholder is hospitalised for a period of 24 hours. Hospitalisation cover includes expenses such as room rent, boarding, nursing, ICU, ambulance service up to 2,000, medical practitioner and consultant fees, operation theatres, PPE kit, gloves, etc.

In case of home care treatments, the policy will cover expenses up to a maximum of 14 days. This is provided a medical practitioner advises the insured to take treatment at home and regular monitoring is done by the medical practitioner. This policy covers for Ayush treatment (in-patient care) as well. It also covers pre-hospitalisation expenses (for a period of 15 days) and post-hospitalisation expenses (for a period of 30 days).

Cornoa Kavach also comes with an optional cover (rider) for additional premium hospital daily cash. The insurer will pay 0.5 per cent of the SI per day up to 15 days, provided the policyholder is hospitalised for 24 continuous hours.

In case of Corona Rakshak policy, the insurer will pay 100 per cent SI upon positive diagnosis and the policy shall terminate thereafter.

Keep in mind

Like any other health policies, the Corona covers too come with a waiting period of 15 days. These policies don’t have any deductibles and come with the option of portability for policyholders.

Do note that the medical test requirement, that is, the process of on-boarding of customers, vary with insurers for both Covid policies. Corona Kavach offers discount of 5 per cent on premium for healthcare workers.

Both policies have certain exclusions to be kept in mind. Any unproven treatments will not be covered. Similarly both policies cease its coverage if the insured travels outside the country where travel restrictions are in place. Additionally, Corona Kavach offers no coverages on day care treatments and OPD (out-patient) expenses..

Take note, expenses made for testing at government-authorised diagnostic centres are covered; expenses at any other centres are not covered.

Should you buy?

Since coverages are the same across insurers, you can select corona policies based on the premium and services offered by an insurer of your choice. Do consider the claim settlement track record of the insurer as well.

One of the advantages in Covid policies are that there is no zone-wise premium. That is, under a regular health policy, your premium amount depends on the medical costs prevailing in a particular city. Which means, those in rural or semi-urban areas could have lower premium compared to those residing in urban areas such as Delhi or Mumbai. But as per regulatory guidelines, these variations in the premium are not allowed to be charged in corona policies.

If you have a comprehensive health policy with OPD (expenses on treatment in out-patient department), it will cover for home treatment expenses as well, so separate Corona Kavach may not be required.

The benefit policy Corona Rakshak could be useful, particularly if your existing health policy doesn’t cover OPD expenses. As some people who are tested positive are home quarantined, this can come in handy to cover immediate medical expenses. As insurers may come up with these two policies from today watch out on premiums before you take a call to buy.

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