With the Insurance Regulatory Development Authority of India (IRDAI) announcing the guidelines for two standard COVID-19 health insurance policies with uniform features, terms and conditions, the insurance companies will offer 'Corona Kavach' and 'Cornoa Rakshak' from July 10 and help people with better health insurance coverage in their fight against the coronavirus pandemic.
It is mandatory for general and health insurers to provide the reimbursement-based standard COVID-19 product, while offering the benefit-based product is optional for all insurers.
Despite being coronavirus-specific policy, the regulator said, the standard indemnity-based COVID-19 policy named as 'Corona Kavach' will cover the cost of treatment of any co-morbid conditions, including pre-existing conditions, along with the treatment for the coronavirus infection or disease with the tenure ranging from 3.5 months to 9.5 months. Notably, an indemnity plan reimburses hospitalisation expenses actually incurred by the policyholder to the extent of the sum insured.
Further, all life, general and health insurance companies have been encouraged to offer standard benefit-based policy, 'Corona Rakshak', which hands out a pre-agreed lump-sum upon diagnosis.
The premium under both the products shall be pan India basis and no geographic location or zone-based pricing will be allowed, according to the IRDAI.
Commenting on the regulator's guidelines on uniform COVID-19 health insurance products, Bharti AXA General Insurance Chief Underwriting and Reinsurance Officer Milind V. Kolhe said, "We welcome the regulator's move to bring the COVID insurance products at the time when it is needed the most. Customer-centricity is the main theme of these products during the unprecedented times.
"The hallmark feature is the uniformity of the policy wordings across the market. Claims management will be an important aspect of these products and insurers are working closely with the General Insurance Council to bring some rationalization in the treatment costs. As a responsible insurer, we are fully committed to creating innovative and productive solutions for the customers in an appropriate manner."
According to the guidelines by the IRDAI, the minimum sum insured for the Corona Kavach Policy will be Rs 50,000 and the maximum sum insured would be Rs 5 lakh. There is also a five per cent discount for healthcare workers. However, for Corona Rakshak Policy, the minimum sum insured would be Rs 50,000 and maximum limit is set at Rs 2.5 lakh.
Corona Kavach policy will be an indemnity-based policy, but optional cover shall be made available on benefit basis. The base cover will offer hospitalization expenses like room and boarding charges along with PPE kits, gloves, masks and such other similar expenses and even AYUSH treatment.
Corona Kavach will also cover home care treatment expenses of up to 14 days, if it involves an active line of treatment and is done on a medical practitioner's advice, among other conditions. Cost of pulse oximeter, oxygen cylinder and nebulisers will also be covered.
Corona Rakshak, the single-premium plan will pay out 100 per cent of the sum insured as lump-sum if the policyholder is hospitalised -- at least for 72 hours -- after testing positive for COVID-19. The sums insured under the product, which will carry tenures of 105 days, 195 days and 285 days, will range from Rs 50,000 to Rs 2.5 lakh. The policy will cease to exist once the claim is paid out.
The minimum entry age for both the policies shall be 18 years and the maximum is 65. Dependent children shall be covered from the age of three months to 25 years. However, only the indemnity policy comes with the family floater option. The policy tenure could be 3.5 months, 6.5 months or 9.5 months, including the waiting period, and health insurance rules such as lifelong renewability, migration, and portability shall not be applicable to these products.
Premiums for both the products shall be the same pan-India and geographic location-based or zone-wise pricing is not allowed. The option to pay premiums in installments is also not available for these products. Both policies shall come with 15 days waiting period, during which no claim will be accepted.
Policyholders can avail of the services on a cashless basis, which shall be arranged by the insurer through network providers.