National Insurance Corona Kavach Policy

National Insurance Corona Kavach Policy Features

Some unique features of Corona Kavach Policy by National Insurance Company are given below:

• The policy covers the cost of consumable items like PPE kits, masks used by doctors and nurses, gloves, footwear, oximeter, nebulizer, Oxygen cylinder, etc. that can add to the overall bill and are usually not covered in a basic health insurance plan
• One of the most important features is that it covers all the coronavirus health insurance claims with or without pre-existing co-morbid conditions like blood pressure, diabetes, kidney ailments, cardiovascular diseases, etc.
• Pre-medical screening is not mandatory to buy insurance cover
• In addition to hospitalization, it also covers home treatment and AYUSH (Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy) Treatment up to the coverage amount
• National Insurance Corona Kavach Policy offers 5% discount on the premium to health care workers; and a 10% discount on online purchase
• Optional hospital daily cash benefit equal to 0.5% of Sum insured is also available
• Medical insurance coverage is provided on both individual and family floater basis
• Cashless treatment is provided at Network Hospitals through TPA

Inclusions of National Insurance Corona Kavach Policy

An insured person can file a claim for the following medical expense under the National Insurance Corona Kavach Policy:

• In this policy, the insurer pays for the cost of COVID-19 hospitalization treatment including the cost of masks, gloves, PPE Kits, Oxygen cylinder, Pulse oximeter, nebulizer and other consumable items
• The policy covers home care treatment expenses up to a maximum of 14 days as suggested by a medical practitioner
• The policy also covers COVID-19 AYUSH Treatment expenses including Ayurveda, Unani, Yoga, Homeopathy, Naturopathy, and Siddha up to the sum insured amount
• If the insured patient has pre-existing co-morbid conditions, they are covered as well
• The policy has no sub-limits on room rent, medicines, doctor’s fees, diagnostic tests and other related charges
• Pre and Post hospitalization expenses are covered for 15 and 30 days respectively
• Optional cover of Hospital daily cash benefit of 0.5% of sum insured is also provided
• The policy premium is eligible for tax benefits under Section 80D of the Income Tax Act

Exclusions of National Insurance Corona Kavach Policy

Corona Kavach policy does not accept claims filed for the following:

• Expenses related to COVID-19 treatment before the completion of the waiting period of 15 days from the policy purchase date
• Medical evacuation and investigation
• Rehabilitation cost
• Respite care and Rest cure
• Cost of dietary supplements
• Any COVID related claim related to diagnosis before the policy purchase
• Dietary supplements and substances
• Unproven Treatments
• OPD Charges and Day Care treatments are excluded as well
• Any diagnosis or treatment taken outside India
• Coverage provided is ceased in case the insured person has a travel history to restricted countries
• If the testing is done at a non-government authorized Diagnostic Centre

National Insurance Corona Kavach Policy Claim Process               

Claim for National Insurance Corona Kavach Policy can be filed for cashless hospitalization and reimbursement:

National Insurance Corona Kavach Policy Cashless Claim Procedure

• Cashless treatment is available in-network hospitals and is subjected to pre-authorization by the insurer or its Third-party Administrator
• Cashless claim request form shall be filled and sent to the TPA/Insurer for authorization
• Once you share medical details and submit a cashless request form to the TPA/ National Insurance Company, pre-authorization letter will be issued to the hospital after the verification
• The claimant needs to sign the discharge papers at the time of getting discharged from the hospital, pay for inadmissible expenses and non-medical expenses
• The Insurer reserves the right to accept or deny the pre-authorization if all the medical details are not submitted
• If the insurer denies cashless treatment, then the policyholder can avail the treatment and submit the claim documents for reimbursement

National Insurance Corona Kavach Policy Reimbursement Claim Procedure

To get claim reimbursement the insured person needs to submit the necessary documents to the Insurance Company/TPA within the stipulated time limit as mentioned below.

Claim Prescribed Time limit for Corona Kavach Policy Claim Reimbursement

• Reimbursement of hospitalization/pre-hospitalization expenses – Document submission to be done within 30 days of date of the hospital discharge
• Reimbursement of Post hospitalization expenses- Document submission to be done within 15 days of completion of post-hospitalization treatment
• Reimbursement of Homecare expenses- Document submission to be done within 30 days of completion of homecare treatment

Claim Notification

Claim notification should be sent to the Insurer/TPA as mentioned below:

• The insurer should be notified within 24 hours of an emergency hospitalization or home treatment on a cashless basis
• And for planned treatment, make sure to inform the insurer within 48 hours of hospital admission

Documents Required for Claims

Following documents need to be submitted to claim for Hospitalization Expenses /Pre-Post Hospitalization Expenses/ AYUSH Hospitalization:

• Relevant claim form to be signed and duly filled
• Copy of the Claimant's passport
• Copy of Claimant’s Photo ID Proof
• Doctor's prescription suggesting hospital admission
• Submit the Hospital bills, payment receipts, and detailed bill with amount break-up from the hospital
• Receipt of advance payments
• Discharge card/summary, pre/post hospitalization claim form, medical history details
• Original Investigation reports including policyholder’s medical test reports from Authorized COVlD-19 diagnostic Centre
• Operation theatre notes for the operation performed along with the surgeon’s report
• Sticker/Invoice of the Implants, as applicable
• Medicine prescriptions is medicines are purchased outside the hospital
• Cancelled cheque by the policyholder or a Copy of proposer’s passbook for electronic fund transfer
• If the claim amount exceeds Rs 1 lakh then the proposer needs to provide KYC proof
• The proposer may also need to submit Legal heir or succession certificate
• Any other document as required by the TPA or Insurer for the claim assessment

Additional documents that need to be submitted for Home Care Treatment:

• Doctor’s certificate advising home treatment with the consent of the COVID-19 positive insured person to avail home care treatment
• Doctor’s discharge certificate mentioning the date of start and completion of home care treatment
• Daily monitoring chart with medical treatment records with the treating doctor’s signature
• In case Home Care Treatment is taken at a non-network hospital, an approval letter copy needs to be submitted

National Insurance Corona Kavach Policy Premium

The premiums for all the policy terms and sum insured options are given below as per the age of the proposer:

Premium Table for 3 ½ months for Corona Kavach Policy Term

(Source: National Insurance Company Limited)

Premium Table for 6 ½ months for Corona Kavach Policy Term

(Source: National Insurance Company Limited)

Premium Table for 9 ½ months Corona Kavach Policy Term

(Source: National Insurance Company Limited)

Discount on Family Floater Basis

National Insurance Corona Kavach Policy FAQs