IRDAI Issues Guidelines for Corona Kavach Policy to Insurers: July 10, 2020

Amid the growing impact of the global pandemic COVID 19, the Indian Regulatory and Development Authority of India has issued guidelines to all the general and health insurance companies in India to provide individual COVID Standard Health Insurance Policy to people. As per the guidelines 'Corona Kavach Policy' & 'Corona Rakshak Policy' need to be issued on or before 10 July 2020. The product is designed to ensure:

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      • A Coronavirus specific product that covers basic health insurance needs related to COVID treatment
      • A standard medical insurance product with common policy wordings across the health insurance industry
      • A policy with no deductibles

      Guidelines:

      • The base product shall be offered on Indemnity Basis and the optional cover should be on the Benefit basis
      • The Standard COVID-19 Insurance policy prices need to be determined keeping in mind the IRDAI health regulations 2016
      • The policy term under the COVID specific product shall be – 3.5 months, 6.5 months, and 9.5 months including the waiting period
      • This is a mandatory product for all the General and Health Insurers
      • 5% discount in premium to be provided to health care workers.

      Features and Benefits of Standard COVID-19 Health Insurance Plans

      Features Benefits
      Coverage Policy to offer coverage on family floater basis as well
      Category of Cover Base Cover: Indemnity Basis
      Optional Cover: Benefit Basis
      Policy Period 3.5 months, 6.5 months, and 9.5 months including the waiting period
      Minimum and Maximum Sum Insured Minimum Sum Insured: Rs 50,000
      Maximum: Rs 5 Lakh
      Modes of premium payment Single
      Entry age Minimum entry age: 18 years
      Maximum entry age: 65 years
      Dependent Child / children: Day 1 to 25 years
      Pricing The premium should be on PAN India basis with no zone-based or geographic location-based pricing
      Renewability Lifetime renewal

      You may like to Read: Best Health Insurance Plans in India

      Basic Coverage under COVID Standard Health Insurance Policy

      1. Hospitalization Expenses (minimum 24 hours of admission)

      The policy shall pay for the hospitalization expenses incurred by the policyholder for COVID treatment in a government authorized diagnostic centre. It includes the following medical expenses

      • Nursing expenses, hospital room rent, and boarding charges
      • Cost of blood, Anaesthesia, oxygen, surgical appliances, operation theatre, ventilator charges, drugs, medicine, diagnostic tests, PPE Kit, mask, gloves, and the likewise
      • It shall also cover the fees charged by the Doctor, Surgeon, Anesthetist, Consultants, Specialist Fees (including telemedicine consultations as per Telemedicine Practice Guideline of March 25, 2020)
      • Intensive Cardiac Care Unit (ICCU) and Intensive Care Unit (ICU) expenses
      • Road Ambulance charges up to Rs 2000 per hospitalization

      2. Home Care Treatment Expenses

      The insurance provider shall cover the cost of COVID treatment at home up to 14 days provided:

      • The insured person has been advised to take treatment at home
      • Monitoring of health is required during home treatment
      • Daily monitoring chart to be maintained and is signed by the doctor
      • Cashless and reimbursement facility as per the claim settlement policy followed by the insurer
      • Reimbursement claim requests to be approved within 2-hours by the insurer
      You may like to Read: Arogya Sanjeevani Health Insurance

      3. Pre and Post Hospitalization

      The policy shall cover pre-hospitalization expenses incurred 15days before the date of hospitalization/home treatment including the cost of diagnosis as per the admissible claim. It shall also cover 30 days of post-hospitalization expenses.

      4. Ayush Treatment

      Ayush hospitalization expenses (as per the IRDAI Health Insurance Regulations, 2016) systems of medicine for the treatment of COVID on Positive diagnosis of COVID in a government authorized diagnostic centre shall be covered up to the Sum Insured without any sub-limits.

      5. Optional Cover

      The insurer shall pay 0.5% of the sum insured amount on daily basis for hospitalization required for 24 hours for treatment of COVID up to a maximum of 15 days during the policy term.

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      Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in

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      *We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30- minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881.

      *Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. Policybazaar does not provide any medical or surgical advice or diagnosis and is not responsible for your interactions / treatment by a medical practitioner/hospital. Please consult a registered medical practitioner for any medical or surgical advice. The Information that you obtain or receive from Policybazaar, and its employees, or otherwise on the Website is for informational purposes only. As per the Insurance guidelines, you are allowed to cancel the policy with-in 30 days from the date of Issuance of policy.This option is available incase of policies with a term of one year or more.

      *All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.

      **All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws. GST Exemptions depend on fulfilment of qualification criteria and submission of relevant documents.

      *₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.

      *₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases

      *₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.

      *₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.

      *No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.

      *The values taken for effective cost calculation are indicative values and may change as per the selected plan.

      *Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.

      *Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.

      *The scope of coverage may vary from plan to plan.

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