Insurance Companies To Offer COVID-19 Specific Insurance Plans

Published On Jun 06, 2020 12:00 AM By Deepali Aggarwal

With the number of coronavirus cases mounting in the country, the Insurance Regulatory and Development Authority of India (IRDAI) has mandatorily asked all general and health insurers to offer a standard individual COVID-19 health insurance plan.

The coronavirus specific health insurance plan which will cover the treatment cost of COVID-19 will be offered by insurance companies latest by or on June 15, 2020. 

What All Will Standard Individual Covid-19 Health Insurance Plan Cover? 

For now, the IRDAI has issued draft guidelines for the designing of the standard individual COVID-19 cover. However, as per the draft guidelines, the following could be the features of the standard COVID-19 health insurance plans:

  • Coverage for treatment of COVID-19 patients in makeshift hospitals. This is not currently covered under existing health insurance policies.
  • The sum insured can range between Rs. 50,000 to Rs. 5 lakh. The ICU charges, room charges, and quarantine charges could be capped at Rs. 10,000 per day, Rs. 5,000 per day, and at Rs. 3,000 per day respectively.
  • The plan could come with a policy tenure of 1 year.
  • The plan could be available on a family floater basis.
  • The minimum and maximum entry age under the plan could stand at 18 years 65 years respectively. 
  • The policy can come with lifelong renewability.
  • The hospitalization cost could cover room, nursing expenses, boarding expenses up to 2% of the sum insured, subject to a maximum of Rs. 5,000 per day. The cover could also include fees paid directly to the hospital, surgeon, or doctor for services offered by surgeons, consultants, medical practitioners, specialists, anesthetists. The plan could also provide coverage for similar expenses like anesthesia, operation theatre charges, blood, medicines and drugs, surgical appliances, oxygen, diagnosis costs, and diagnostic imaging modalities.
  • The plan can also provide coverage for ICU expenses up to 5% of the sum insured subject to a maximum of Rs. 10,000 per day. 
  • The plan could cover a maximum of Rs. 2,000 for expenses incurred on road ambulance. 
  • The policy can cover all daycare treatments.
  • The coronavirus specific plan can also provide coverage for expenses incurred on hospitalization under AYUSH medicine without sub-limits.
  • The plan could cover pre-hospitalization expenses of 30 days including the COVID-19 diagnostic costs.
  • The plan can also provide for post-hospitalization expenses for a period of 60 days from the date of discharge from the hospital.
  • As many as 2 add-on covers namely Quarantine Cover and Hospital Daily Cash cover could be allowed to be offered along with the standard COVID-19 plan.
  • In case an individual is under quarantine due to diagnosis or suspected infection, the insurance company could be bound to pay 1% of the sum insured per day subject to a maximum of Rs. 3,000 per day under the Quarantine Cover.
  • In case an individual is tested positive for COVID-19, the plan could provide for 0.5% of the sum insured per day as daily hospital cash for every 24 hours of hospitalization.

According to the guidelines issued by IRDAI, the standard COVID–19 health insurance plan can come with a premium payable on a monthly, quarterly, half-yearly, and yearly basis.

As of June 6, 2020, the pandemic declared coronavirus has infected more than 6.7 million people across the globe. According to the latest data shared by the Ministry of Health and Family Welfare, there are more than 2.3 lakh positive coronavirus cases reported in India.

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"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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