‘Corona Kavach’ & ‘Corona Rakshak’ –Standard COVID Health Insurance Plans

Ashish M. Shaji

13 Jul, 2020

Amidst the growing implications of the Covid-19 pandemic, the IRDAI has issued guidelines directing all the general insurance companies and health insurance companies in India to provide COVID Standard Health Insurance policy to people. The policies are named ‘Corona Kavach’ and ‘Corona Rakshak’ policies, which must be issued on or before July 10, 2020.

What is the difference between “Corona Kavach and Corona Rakshak” health insurance plans?

The standard product offered by the IRDAI that is the Corona Rakshak policy is a standard benefit based policy. Corona Kavach policy is a standard health policy that shall be provided on an indemnity basis.

The corona Rakshak policy shall offer coverage on a benefits basis, whereas the basic cover of Corona Kavach shall be provided as per the compensation principle.

What does the product ensure?

It is a corona virus-specific product that covers basic health insurance requirements pertaining to the Covid-19 treatment. It is a standard medical insurance product with common policy wordings across the health insurance sector. It is a policy with no deductibles.

What are the guidelines issued by the Insurance Regulatory and Development Authority of India (IRDAI) pertaining to these products?

The following guidelines were issued by the IRDAI:

• The base product shall be provided on an indemnity basis, and the optional cover will be on a benefits basis;
• The prices of the Standard Covid-19 Insurance Policy must be determined according to the IRDAI health regulations 2016^[1];
• The policy term of the Covid specific product will be 3.5 months, 6.5 months and 9.5 months including the waiting period;
• It is a mandatory product for all General and Health insurers; and
• A 5% discount to be provided in premium to health care workers.

What are the main features of the Standard Covid-19 Health Insurance Plans?

The main features of these health insurance plans are as follows:

• As far as coverage is concerned the policy will offer coverage on family floater basis as well;
• The category of cover includes Base cover on an indemnity basis and optional cover on a benefits basis;
• The period of the policy shall be 3.5 months, 6.5 months and 9.5 months including the waiting period;
• The minimum and maximum sum insured will be 50,000 rupees and 5 lakh rupees respectively;
• It will be a single premium payment method for both policies;
• The minimum  entry age for this policy shall be 18 years, and the maximum entry age will be 65 years;
•  As a family floater it shall cover the parents, parents in law and dependent children up to the age of 25 years; and
• The premium shall be on PAN India basis with no zone based or geographic location Based pricing;

Basic coverage under the Covid Standard Health Insurance Plans

Expenses of hospitalization

The policy shall cover the hospitalization expenses incurred by the policyholder for the treatment of COVID-19 in a government authorized diagnostic center. It shall cover the following medical expenses:

• Nursing expenses, rent of the hospital room and boarding charges;
• Cost of blood, Anaesthesia, oxygen, operation theatre, surgical appliances, ventilator charges, medicine, drugs, PPE kit, diagnostic tests, mask, gloves and likewise;
• It shall further pay for the charges of the Doctor, Surgeon, Consultants, Anaesthetist, Specialist fees (including the tele-medicines consultations according to the telemedicine practice guideline dated March 25, 2020);
• Expenses of the Intensive Cardiac Care Unit (ICCU) and Intensive Care Unit (ICU); and
• Expenses of road ambulance up to 2000 rupees per hospitalization.

Expenses of Home Care Treatment

The insurance provider will be covering the cost of the treatment for Covid at home up to 14 days provided:

• The insured person has been asked to get treatment from home;
• Monitoring of health is needed during home treatment;
• A daily monitoring chart must be maintained, and the same should be signed by the doctor;
• The insurer follows the cashless and reimbursement facility according to the claim settlement policy; and
• Reimbursement claim request is approved within two hours by the insurer.

Expenses of Pre and Post Hospitalization

The policy will be covering expenses accruing from pre-hospitalization incurred 15 days prior to the date of hospitalization or home treatment, including the diagnosis costs as per the admissible claim. It shall also cover post-hospitalization expenses of 30 days.

Ayush Treatment

The expenses of Ayush hospitalization according to the IRDAI Health Insurance Regulations, 2016, systems of medicine for the COVID treatment on a positive diagnosis of COVID in a government authorized diagnostic centre will be covered up to the sum insured without any sub-limits.

Optional Cover

During the term of the policy, the insurer is required to pay 0.5% of the sum insured amount on a daily basis for hospitalization needed for 24 hours of treatment of Covid up to 15 days maximum.

How is the new health insurance plans expected to fare?

Since the product features and terms are standardized, premium, and cashless hospital network will form a key factor once the insurers commence with the products. The policy may prove to be beneficial for those who are looking for less expensive covers. Policyholders can also be benefited as the cost of the PPE, masks, gloves, and home health care is covered under the plan.

These policies are attractive and provide a good beginning for people to select health insurance and may encourage them to choose for a holistic health insurance cover later on. It is an effective policy to save on your savings, which may otherwise be affected due to the implications of the covid-19 pandemic.

Conclusion

Also, read: Covid-19 Impact on Heath and Life Insurance