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Does Dengue and Pneumonia Covered Under Health Insurance

Updated On Dec 04, 2020

Whenever the Dengue season is around and we start hearing cases of infections around us, it is natural to become scared as there is no medicine to treat it. Another dreaded infection is Pneumonia which can be caused by a variety of organisms, including virus, bacteria, and fungi. Both these diseases can often progress from being mild, treatable at home with proper care, to complications requiring hospitalization. In case of hospitalisation, would your health insurance cover the expenses? Let’s find out.

Regular Health Insurance Plan For Dengue and Pneumonia 

Health Insurance plans that provide all-inclusive coverage take care of hospitalization expenses. As mentioned above, often dengue and pneumonia do not require hospitalization and can be treated at home. These diseases are covered in health insurance plans which provide an umbrella cover for a vast number of diseases.

However, the costs due to diagnostic tests, medications, and nursing care which may end up being paid out-of-pocket if not covered under the plan. The hospitalization charges usually range between Rs. 40,000 to Rs. 50,000 and these aren’t uncommon. Sometimes it could be above Rs. 1 lakh, as well. Thus, a claim takes away  a considerable amount from the available coverage and that can be a drawback if the patient develops a critical illness and then the coverage amount falls short.

Specific Health Insurance Plan/Rider For Dengue and Pneumonia

Dengue and Pneumonia are diseases which cause deaths in large numbers throughout the world due lack of treatment. Recognizing this need, certain insurance providers have come up with specific coverage in recent years for dengue and pneumonia. Alternatively, specific illness riders are also being offered to help customers manage their sum insurance and allocations more efficiently.

Benefits of Specific Dengue and Pneumonia Health Insurance Plan

The specific illness plans that are there for Dengue and Pneumonia have the following benefits:

1. Protects Sum Insured of Base Plan: Specific coverage with a separate policy would protect the sum insured of the policyholder’s base plan. 

2. Low Premium: Additionally, specific coverage is usually available at very low premium.

3. No Restriction on Entry Age: As anyone irrespective of age can get an infection, there is no restriction on age for such policies.

4. Higher Chances of Claim Approval: Specific coverage plans are customized taking into consideration the nature of disease progression, treatment etc. Thus, criteria for reimbursement of expenses are usually less stringent and claims have higher chances of getting approved. 

For example, claim due to hospitalization exceeding 24 hours but less than 48 hours may be admissible in a dengue health insurance plan but not in a comprehensive coverage (may require hospitalization for 48 hours or more)


Health insurance premiums are getting expensive due to various factors. The same sum insured may sometimes get dearer by around 10% year-over-year. This restricts insured individuals from opting for a higher insurance amount as they have to pay even more. In cases like these, careful evaluation of plans that provide specific coverage for illnesses with higher prevalence or riders on the base plan that work in a similar fashion, is often a better solution to avail coverage at a lower overall premium payment.
Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.

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