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Insurance claim for Coronavirus

Articles | Niva Bupa

How to make an insurance claim for Coronavirus

Niva Bupa

07 October 2020

The Covid-19 pandemic has had devastating  impact on the world, and, as a result insurance policy holders remain unsure about whether their family health insurance plans or individual health insurance plans  will provide them with cover against the disease, should they contract it.       

In order to soothe some of this uncertainty, the IRDAI (Insurance Regulatory and Development Authority of India) has mandated that post the announcement on the 26th of July, 2020, all major insurance companies were to provide Covid specific healthcare policies with the objectives of addressing basic Covid-19 related health needs of the public and to have a standardized product across the industry. As a result, various insurance companies began developing their insurance policies in accordance with these guidelines under the titles of “Corona Kavach” . This article will discuss these specific insurance policies, only for Coronavirus,  alongside a step-by-step breakdown of the process of filing an insurance claim for Coronavirus.


The Difference between Corona Kavach & Traditional Health Insurance -

 

It is important to know that the purpose of each of these health insurance policies is different. A Corona Kavach is aimed at providing financial aid for hospital expenses for COVID-19 positive patients only, a Corona Rakshak policy is more of an income replacement, for COVID-19 positive patients. However, both serve as additions to your existing health insurance plans.

 

Here are some of the differences between a regular health insurance plan and Corona Kavach -

 

Period of Treatment: Corona Kavach covers the cost of treatment at home for 14 days for a patient tested covid positive and don’t require hospitalisation which may not be the case for your health insurance.

Equipment: Corona Kavach also covers the cost of PPE kits and other equipment, which would be needed, which standard health insurance plans may not cover.

Pre-existing diseases Corona Kavach are planned to cover  all pre-existing diseases in case of gospitalisation due to positive Covid-19. Whereas in a HI policy, PED come with a waiting period.

 

Types of claims -

 

1. Reimbursement claims :

 

If you have the financial stability to pay for a hospital bill upfront, you can opt to seek reimbursement on those expenses afterwards. You need to complete a claims form along with the necessary set of documents and proof of the expenses paid in the form of discharge papers and various bills. This needs to be verified by the hospital as well with an official seal before it is sent to the insurance company to be approved. This can also be done online through the insurance company’s portal. At a time when social distancing is high on our list of priorities, online claims have gained popularity.

 

2. Cashless claims:

 

This is a quick and efficient way of processing a sum assured to be paid directly from the insurance provider to the hospital at which the insured person is receiving treatment.

You can do this by speaking with the customer care at the health insurance company and register your claim by giving them the required details such as your policy IDand details about the hospital. This hospital will need to be a part of the approved network of treatment facilities as per your insurer for the cashless claim to be approved. The insurer then speaks with a representative at the hospital from which they receive all the documents they need to scrutinize before approving and processing the sum. If the bill exceeds the sum assured as per the insurance policy, the policyholder will need to pay for the treatment themselves.

 

Conclusion:

There are several myths about Coronavirus that continue to circulate, however, it is important to remain vigilant in case you develop any symptoms of the illness. One must care for themselves with supplements to boost immunity beforehand so as to provide an additional layer of protection against the disease. However, if you do contract the disease, follow the steps, and inform your health insurance provider to ensure that you get the care you need well in time.

 

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