Corona Kavach health insurance for Covid19, Corona health insurance, Covid 19 medical insurance

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Corona Kavach COVID Insurance Policy

As on 10th July 2020, there were 850,000 Corona patients in India and although around 50% of them recovered, there is still a lot of interest in having an insurance coverage that covers Covid-19-specific treatments. While the Insurance Regulatory and Development Authority of India (IRDAI) has standardized corona-specific covers in terms of policy features and wordings, the interpretation on the coverage may be different across insurers.Exclusive health insurance plans for Covid-19 hospitalization treatment have been introduced in the market from July 10, 2020 called Corona Kavach Policy. According to the IRDAI, this Corona Standard Health Policy need to be compulsorily offered by all general and health insurance companies from July 10, 2020. What makes Corona Kavach Policy a simple product to buy is that every insurer needs to carry common set of benefits and applicable policy wordings. The features and the premium will similar across all the insurers. So, now if anyone wants to buy a health cover to guard against Covid-19 related hospital expenses, one can buy it from any insurer given the commonality in terms of benefits. The product has been introduced to ensure:
  • Coronavirus specific product introduced that covers health insurance expensed related to COVID treatment
  • Indemnity Plans available in both Individual and Family Floater options
  • Standard product with similar benefits and policy wordings which is mandatory across all health and general insurance companies
Due to the quick spread of highly-infectious Novel Coronavirus Covid-19, panic-stricken individuals are feeling anxious and scouting around to take an appropriate health insurance cover. However, taking a full-fledged health insurance policy will not only be expensive, but wouldn’t even solve the immediate purpose of Covid coverage due to a long waiting period.

Also, most insurers, will only pay for treatments that the government has authorized for covid-19. This means that it’s difficult to ascertain if an insurer will pay for a treatment (like plasma therapy) that may be based on newer research internationally, unless the Indian government approves it.

Many insurers do not cover personal protective equipment (PPE) in their regular policies. Corona Kavach covers this. Since it is a disease-specific plan, it will pay for things that a regular insurance plan would not.Considering the complexity of the disease and the treatment, it is advisable that you choose an adequate Sum insured, bearing the following factors in mind:
  • Age of the Proposer / Policy Holder (especially in case of Family Floater)
  • Current Health Condition of the Proposer
  • Locality (Metro/Non-Metro /Town)
  • Age of Dependents and their Current Health Condition (Co-Morbidity)

Features of Corona Kavach medical insurance for Coronavirus

The feature of Coronavirus mediclaim insurance include:
Product Type Available on Individual and Family Floater Basis
Coverage Basis
  1. Base Cover on Indemnity Basis- Covid19 Hospitalization cover
  2. Optional Cover on Benefit Basis- Hospital Daily Cash
Sum Insured ₹50,000/- (Fifty Thousand) to ₹5,00,000/- (Five Lacs) (in the multiples of fifty thousand)
Eligibility of Insured
  • Adults: Persons between the age of 18 to 65 years can be the insured member under the policy.
  • Children: Children upto the age of 25 years
Self, spouse, Parents, Parents-in-law and Dependent Children are the family members that can be covered
Waiting Period 15 days
Policy Period Options
  • Three and Half Months (3 ½ months)
  • Six and Half Months(6 ½ months)
  • Nine and Half Months (9 ½ months)
These policy duration is including waiting period of 15 days.
Premium payment Single Premium
Hospitalization Expenses Medical Expenses of Hospitalization related to Covid 19 (upto to the Sum Insured chosen) on diagnosis shall be payable under this plan
Pre Hospitalization Expenses 15 days
Post Hospitalization Expenses 30 days
Sub-limits
  • Home care treatment: Maximum upto 14 days per incident.
  • Ambulance Charges: Rs.2000/- per hospitalization.
  • Optional Cover of Hospital Daily Cash: 0.5% of Sum Insured per day subject to maximum of 15 days in a policy period for every insured member.
Renewability Lifetime Renewal
Home Care Treatment Expenses Cost of treatment incurred by the Insured person on availing treatment at home for Covid on positive diagnosis up to 14 days per incident, which in the normal course would require care and treatment at a hospital but is actually taken while confined at home.
Hospital For the purpose of this policy any set-up designated by the government as hospital for the treatment of Covid shall also be also considered as hospital.
Premium Standardised across India for all geographies

Benefit Coverage Description

  1. Hospitalization Expenses (minimum 24 hours of admission) Corona Kavachpolicy will pay for the hospitalization expenses incurred by the policyholder for treatment related to Covid 19 in a government authorized diagnostic medical facility. It includes the following medical expenses:
    • Room Rent, Boarding, Nursing Expenses as provided by the Hospital/ Nursing Home
    • Surgeon, Anaesthetist, Medical Practitioner, Consultants, Specialist Fees whether paid directly to the treating doctor or to the hospital
    • Intensive Care Unit (ICU) and/or Intensive Cardiac Care Unit (lCCU) expenses
    • Anaesthesia, blood, oxygen, operation theatre charges, surgical appliances, ventilator charges, medicines anddrugs
    • Costs towards diagnostics, diagnostic imaging modalities, PPE Kit, gloves, mask and such similar otherexpenses
    • Road Ambulance subject to a maximum of Rs.2000/- per hospitalization for the Ambulance services offeredby a Hospital or by an Ambulance service provider, provided that the Ambulance is availed only in relation toCovid Hospitalization
  2. Home Care Treatment Expenses The insurance provider shall cover the cost of treatment at home up to 14 days on positive diagnosis of Covid in a Government authorized diagnostic Centreprovided:
  3. The Medical practitioner advices the Insured person to undergo treatment at home.
    • Daily monitoring chart including records of treatment administered duly signed by the treating doctor is maintained.
    • There is a continuous active line of treatment with monitoring of the health status by a medical practitioner foreach day through the duration of the home care treatment.
    • ln this benefit, the following shall be covered if prescribed by the treating medical practitioner and is related totreatment of Covid:
      • Diagnostic tests undergone at home or at diagnostics centre
      • Medicines prescribed in writing
      • Nursing &Consultation charges of the medical practitioner
      • Cost of Pulse oximeter, Oxygen cylinder and Nebulizer
  4. The Cashless and Reimbursement facility as per the claim settlement policy of the insurer. Reimbursement claim requests to be approved within 2-hours by the insurer.
  5. AYUSH Treatment AYUSH hospitalization expenses, as per the IRDAI Health Insurance Regulations, 2016 for the treatment of COVID on a Positive diagnosis in a government authorized diagnostic centre shall be covered up to the Sum Insured without any sub-limits.
  6. Pre and Post Hospitalization The policy shall allow for coverage of pre-hospitalization expenses incurred upto15days before the date of hospitalization/home treatment including the cost of diagnosis as per the admissible claim. It shall also cover 30 days of post-hospitalization expenses, post discharge from a medical facility or home treatment.
  7. Optional Coverage The insurer shall pay 0.5% of the sum insured amount on daily basis for hospitalization required for 24 hours for treatment of COVID up to a maximum of 15 days during the policy term.
    There are however some Limitations in this plan as well:
    • Age: Many seniors may not be eligible to buy this policy since the maximum age of entry for Corona Kavach is 65 years. As per the data provided by the ICMR in India, more than 70% of the affected belong to an age category above 65 years
    • Pre-existing Disease Coverage : For PED there is no standard approach across all insurance companies and the proposal will be evaluated on the basis of the medical history of the individual and the medical records.
    • Co Morbidity Coverage : It needs to be ascertained if all insurance companies will cover complications due to co-morbidity under this plan.

India health insurance companies offering Covid19 Corona Kavach coronavirus coverage
Travel Insurance Plans reliance travel insurance Future Generali Insurance plans Iffco Tokio Insurance Plans ManipalCigna Insurance Plans Universal sompo Insurance Plans oriental health insurance Kotak General Secure Shield Insurance Godigit Insurance Plans

Covid-19 Corona Kavach Indian health insurance review

  • Claims Process
  • Limitations
  • Exclusions

Claims Process for Corona Kavach

Cashless Claims Process Reimbursement Claims Process
Step 1 Approach a Network Hospital of the respective insurance company, who will verify your details and send it ahead to the insurer for authorization In case of hospitalization notify the insurer of your admission in network or non network hospital. After getting admitted and at the time of discharge, settle bills directly to the hospital.
Step 2 Based on the information received from the hospital, the claim will be approved based on admissibility, within 24 hours. The insurer may seek clarifications from the hospital in case of certain queries, post which an authorization letter is sent to the hospital within 7 days. On discharge, please ensure to collect all relevant documents, invoices, medical reports and discharge certificate from the Hospital in originals.
Step 3 Once your authorization is in place, insured can get admitted, get treated and be discharged. Insurer will coordinate with the hospital and clear all the necessary medical bills and costs. Send these documents and the completely filled and signed claim form to the insurer along with your valid ID proof and age proof. The claim form is available on the company website and in your policy document kit as well.
Step 4 Post approval the reimbursement will be made subject to admissibility,

Documents needed for processing a claim

For Hospitalization claims (Cashless & Reimbursement):
  • Duly filled and signed Claim Form
  • Copy of photo Identity proof
  • Medical practitioner's prescription advising admission
  • Original bills with itemized break-up
  • Payment receipts
  • Discharge summary including complete medical history of the patient along with other details
  • Investigation reports including your test reports from Authorized diagnostic centre for COVID
  • OT notes or Surgeon's certificate giving details of the operation performed, wherever applicable
  • Sticker/Invoice of the Implants, wherever applicable
  • NEFT Details (to enable direct credit of claim amount into bank account) and cancelled cheque.
For Home Treatment claims:
  • Duly filled and signed Claim Form
  • Copy of photo Identity proof
  • Medical practitioner's prescription advising admission + a certificate from medical practitioner advising treatment at home or your consent on availing home care benefit
  • Discharge Certificate from the medical practitioner specifying date of start and completion of home care treatment
  • Daily monitoring chart (including records of treatment administered duly signed by the treating doctor)

Exclusions of Corona Kavach Policy

The insurance company shall not be liable to make any payment under the policy, in respect of any expenses incurred inrespect of:
  • Any claim in relation to Covid where it has been diagnosed prior to Policy Start Date.
  • Any expenses incurred on Day Care treatment and OPD treatment
  • Investigation & Evaluation - Expenses related to any admission primarily for diagnostics and evaluation purposes. Any diagnostic expenseswhich are not related or not incidental to the current diagnosis and treatment
  • Rest Cure, rehabilitation and respite care - Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. This alsoincludes:
    • Custodial care either at home or in a nursing facility for personal care such as help with activities of daily livingsuch as bathing, dressing, moving around either by skilled nurses or assistant or non-skilled persons
    • Any services for people who are terminally ill to address physical, social, emotional and spiritual needs.
  • Dietary supplements and substances that can be purchased without prescription, including but not limited toVitamins, minerals and organic substances u n less prescribed by a medical practitioner as part of hospitalizationclaim or Home care treatment.
  • Unproven Treatments - Expenses related to any unproven treatment, services and supplies for or in connection with any treatment.Unproven treatments are treatments, procedures or supplies that lack significant medical documentation tosupport their effectiveness. However, treatment authorized by the government for the treatment of COVID shallbe covered.
  • Diagnosis /Treatment outside the geographical limits of India
  • Testing done at a Diagnostic centre which is not authorized by the Government shall not be recognized underthis Policy
  • All covers under this Policy shall cease if the Insured Person travels to any country placed under travel restrictionby the Government of India

FAQs for Corona Kavach medical insurance for Covid19

You can avail coverage from ₹50,000/- (Fifty Thousand) to ₹5,00,000 (Five Lacs) under Kavach plan, a specific health insurance policy for coronavirus treatment.The policy can be bought on Individual basis where the sum insured shall apply to each individual family member. In family floater plan, sum insured shall apply to the entire family.

An Individual can avail this policy to take care of their treatment expenses arising out of Covid-19 and avoids out of pocket expenses. In the case of existing health insurance policyholders, holding an additional Covid-specific policy would make the coverage more comprehensive.Unlike a basic health insurance policy, a Covid specific policy covers medical treatment incurred during home quarantine and at Covid care centres, even if it does not ultimately lead to hospitalisation. Additionally, the policy covers expenses towards PPE's, masks, gloves, oximeters, oxygen cylinders, nebulisers, AYUSH treatment etc.

This plan will cover the medical expenses incurred for hospitalisation of the insured person during the Policy period for the treatment of Covid-19 on positive diagnosis of the condition in a government authorized diagnostic centre including the expenses incurred on treatment of any co-morbidity along with the treatment for Covid-19 up to the Sum Insured specified in the policy schedule, for

  • Room Rent, Boarding, Nursing Expenses as provided by the Hospital/ Nursing Home.
  • Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses.
  • Surgeon, Anaesthetist , Medical Practitioner , Consultants, Specialist Fees whether paid directly to the treating doctor / surgeon or to the hospital.
  • Anaesthesia, blood, oxygen, operation theatre charges, surgical appliances, ventilator charges, medicines and drugs, costs towards diagnostics, diagnostic imaging modalities, PPE Kit, gloves, mask and such similar other expenses.
  • Road Ambulance subject to a maximum of Rs. 2000/- per hospitalisation for the Ambulance services offered by a Hospital or by an Ambulance service provider, provided that the ambulance is availed only in relation to Covid-19 hospitalisation

This policy can be availed by persons between the age of 18 Years and 65 Years, as Proposer. Proposer age aged more than 65 can obtain a Coronavirus health insurance policy for their family, without covering self. Policy can be availed for self and the following family members

  • Legally wedded spouse
  • Parents & Parents-in-law
  • Dependent Children (i.e natural or legally adopted) between the day 1 of age to 25 years. If the child above 18 years of age is financially independent, they shall be ineligible for Coronavirus health insurance plan.

The insurer will cover the cost of treatment incurred by the insured person for availing treatment at home for Covid-19 on positive diagnosis of the condition in a Government authorized diagnostic Centre for up to 14 days per incident, which in the normal course would require care and treatment at a hospital but is actually taken while confined at home subject to policy terms and conditions.

Three and half months (3½ months), Six and half months (6½ months), Nine and half months (9½ months) including waiting periods are the tenure options.

Medical Expenses incurred for inpatient care treatment for Covid-19 under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines shall be covered up to sum insured during the tenure of this coronavirus health insurance policy period as specified in the policy schedule.

Yes. You can avail a tax benefit available under Section 80D of the Income Tax Act 1961 by buying a health insurance policy. Every taxpayer can avail an annual deduction of Rs. 15,000 from his/her taxable income for premium for self, spouse and dependent children. For senior citizens, this amount is Rs. 20,000. Please note that you will have to show the proof of payment of premium. (Section 80D benefit is in addition to the exemption of Rs 1,50,000 under Section 80 C). Tax benefits are subject to changes in the tax laws, please consult your tax advisor for more details.

Yes, Corona Kavach health insurance policy covers comorbidities and pre-existing comorbidities. This is however subjective to each insurance company, so check the policy wordings before making a decision.

Yes. You can avail a tax benefit available under Section 80D of the Income Tax Act 1961 by buying a health insurance policy. Every taxpayer can avail an annual deduction of Rs. 15,000 from his/her taxable income for premium for self, spouse and dependent children. For senior citizens, this amount is Rs. 20,000. Please note that you will have to show the proof of payment of premium. (Section 80D benefit is in addition to the exemption of Rs 1,50,000 under Section 80 C). Tax benefits are subject to changes in the tax laws, please consult your tax advisor for more details.

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