Insurance Regulatory and Development Authority of India (IRDA) has reviewed and revised the proposed standard COVID-19 health insurance policy. As per the new revision, all general and health insurance companies have to offer two insurance products. The first one being an indemnity and the second one as a benefit-based health product for COVID-19 from July 15. Amid other modifications, the terms for covering the cost of PPE kits and room rent stands out.
The minimum admission age for both the policies shall be 18 years and the maximum is 65 years. Dependent children shall also be covered from the age of three months to 25 years. The policy tenure could be three months, six months, or a year.
Indemnity policy
The revamped policy will have a cover on the sum insured up to ₹5 lakh and the minimum sum insured be ₹50,000. Insurers are permitted to offer one optional cover, the premium for which will be stated respectively.
The policy will pay for hospitalization expenditures incurred by the policyholder for the treatment of COVID-19 on a positive diagnosis from a government-approved medical center. It will also cover room and nursing expenses. The cover includes other expenses such as oxygen, operation theatre charges, surgical appliances, drugs and medicines, PPE kits, and gloves if hospitalized for a minimum of 24 hours. The intensive care unit and cardiac care unit charges will be covered as well. The policy will also cover the expenses of treatment at home given the doctor recommends home treatment and there is a need for ongoing treatment that requires monitoring of well-being by a medical practitioner through the duration of the home care treatment. The policy offers an optional hospital daily cash cover in which the insurer will pay up to 0.5% of the sum insured for every 24 hours of hospitalization. This will be due for about 15 days during the policy period. However, the regulator has left it to the insurance company’s choice to determine the premium.
Benefit-based policy
The policy shall pay a lump sum perk equivalent to 100% of the sum insured if the policyholder is tested positive for COVID-19 and requires hospitalization for a minimum period of 72 hours. The product shall cover an individual only. The minimum sum insured shall be ₹50,000 and the upper limit is up to ₹3 lakh. An individual will be allowed to purchase only one such policy. The policy comes with 15 days waiting period window during which no claim will be encouraged.
