Hyderabad:
In view of the global pandemic Covid-19, the insurance regulator IRDAI has decided to mandate all general and health insurers to offer a standard individual COVID-19 health insurance product by June 15.
The insurance regulator has prepared an elaborate draft guidelines outlining the basic features, including permissible insurance claims for various charges,in this cover.There has been demands from the various segments that government and relevant authorities should control the higher charges by fixing a standard rates to be billed by the private sector hospitals for the treatment of Covid-19 pandemic.
Though,some of the general insurers launched exclusive Covid-19 covers,they haven't seen much demands from the customers. However, majority of the general insurers didn't opt to launch exclusice Covod-19 covers, as they have been maintaining that their existing health covers can always take care of Covid-19 treatment.
“Ending all confusions,IRDA promoted by the government has made it mandatory for all the general insurers and health insurers to lauch standard Covid-19 covers.But, customers would always prefer a normal health insurance policy that also covers Covid-19 treatment over an exclusive Covid-19 policy,'' said analysts.
Till Wednesday,the general and health insurers have already received over 8000 claims for about Rs 145 crore for Covid-19 treatments
The Covid-19 policy tenure will be for one year, and it can be given on a family floater basis for persons with minimum entry age of 18 years and maximum of 65 years. However, it will be subject to lifelong renewability.The minimum sum insured should be Rs 50,000 and the maximum will be Rs 5 lakh((in the multiples of fifty thousand).The insurer may determine the price keeping in view the covers proposed to be offered subject to complying with the norms specified in the IRDAI (Health Insurance) Regulations, 2016,the IRDAI said. .
Some of the salient features of the proposed Covid-19 cover will be:
• To have a standard product with common policy wordings across the industry
•Only two add-ons as specified, are allowed to be offered along with the standard Covid-19 product. The premium payable towards these two add-ons are to be specified separately so as to enable policyholders pick, choose and pay based on the need.
•The Base Covers of Standard Covid-19 Product shall be offered on indemnity basis whereas Add-ons shall be made available on Benefit Basis. The policy tenure of the standard Covid-19 product shall be for a period of one year.
The Standard COVID-19 Health Product shall offer the following:
• Room, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home up to 2% of the Sum insured subject to maximum of Rs.5000/- per day.
• AYUSH Treatment: Expenses incurred on hospitalisation under AYUSH (as defined in IRDAI (Health Insurance) Regulations, 2016) systems of medicine shall be covered without any sub-limits.
• Pre-Hospitalisationmedical expenses incurred for a period of 30 days prior to the date of hospitalisation shall be admissible. Pre hospitalization expenses shall cover the costs of diagnostics towards COVID – 19.
• Post Hospitalisationmedical expenses incurred for a period of 60 days from the date of discharge from the hospital, following an admissible claim shall be included.
• No deductibles are permitted in this product.
Add-on covers:
• Quarantine Cover: If the Insured Person is Quarantined due to diagnosis or suspected infection of Covid-19 then the company will pay 1% of sum insured per day subject to maximum up to Rs 3000/day.Any one of the Covid-19 hospitalization cover or quarantine cover shall be payable at a time.•
• Hospital Daily Cash: The company will pay 0.5 per cent of sum insured per day for every completed 24 hours of hospitalization for treatment of Covid-19 on positive diagnosis of disease.
• No plan variants are allowed.
• Minimum entry age shall be 18 years for principal insured and maximum age at entry shall be 65, complying to Regulation 12(i) of HIR 2016, along with lifelong renewability. There shall be no exit age.
• Policy is subject to lifelong renewability.and dependent Child / children shall be covered from the age of 3 months to 25 years subject to the definition of ‘Family’
Room and ICU charges:
•Room Rent, Boarding, Nursing Expenses all inclusive as provided by the Hospital / Nursing Home up to 2% of the sum insured subject to maximum of Rs.5000/- per day.
•Intensive Care Unit (ICU) charges/ Intensive Cardiac Care Unit (ICCU) charges all inclusive as provided by the Hospital / Nursing Home up to 5% of the sum insured subject to maximum of Rs.10,000/-, per day
•Ambulance: Rs 2000/- per Hospitalization.
•1% of sum insured per day subject to maximum up to Rs 3000/day..Hospital Daily Cash: 0.5% of SI/Day
• Expenses incurred for Inpatient Care treatment under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines shall be covered uptosum insured, during each Policy year as specified in the policy schedule.