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Health Insurance

Coronavirus: Be prepared with the right health insurance policy that is claim ready

With Covid-19 outbreak, the demand for health insurance has seen growing. However, policyholders have several concerns related to policy clauses. The major one being whether Covid-19 is covered under their health insurance policies or not. So, the answer to this query is Yes! It is covered under the health plans. As not long after the beginning of the COVID-19 pandemic, the Insurance Regulatory and Development Authority of India (IRDAI) mandated all health insurance providers to cover Covid-19 under standard health insurance policies. To know all these, you should focus on choosing the right health insurance policy rather than just buying it.

Coronavirus: Be prepared with the right health insurance policy that is claim ready

The regulator even instructed insurance providers to be wary while dismissing the claims related to COVID-19 and give appropriate reasons to the client for rejecting the claim. But still over the past few months, customers’ have raised several other issues despite exact explanation by the administrative body.

Some common issues are – would a hospital cover a client having a health insurance policy for isolation because of suspected Covid infection? Likewise, will the insurance company accept the claim if a client decides to get hospitalised in the wake of testing positive for COVID-19 just to ensure that the condition doesn’t deteriorate further? What’s more, if a client decides to undertake home treatment for COVID-19 as opposed to getting hospitalised, would the costs for home treatment be covered under a standard health insurance policy? 

These are some of the usual inquiries that individuals are concern about prior filing the claim related to COVID-19. Well, to enjoy a hassle-free claim experience, you should follow the right claim process. And the process to file COVID-19 claim is same as any other claim, but you need to be a bit extra cautious.

However, you first need to choose whether you would opt for a cashless claim by taking the treatment at any network hospital of your insurer or undertake the treatment at a hospital of your preference and later reimburse the expenses.

In a cashless treatment, you don’t have to worry about the hospital bill as it gets settled directly between the hospital and the insurer. Whereas in the reimbursement process, you have to decide the whole bill all alone. The expenses incurred by you for the treatment gets later repaid to you by the insurance provider which are subject to approval from the insurer. 

Under both the claim process, it is significant for you to initially inform the insurance provider about your hospitalisation and file a claim request. For the comfort of the clients, all the insurance companies have been advised by the administrative body that any case identified with COVID-19 must be sorted out within 2 hours of the request filed. And insurers have also set up a dedicated claim team to look after claims related to the only coronavirus. This team stays in direct touch with the client so that their claim request gets processed in the minimum possible time.

For benefiting the treatment of COVID-19, the hospital will initially test you for Covid by doing a PCR test. According to state government rules, the private labs all through the country have been asked to cap the cost of the tests, and a test is only allowed to be conducted at a NABL-licensed research facility. 

Your insurance provider will cover you for COVID-19 test expenses if you are admitted in the hospital for taking coronavirus treatment. In all cases, charges acquired 30 days earlier and post hospitalisation is included in the ambit of pre and post hospitalisation expenses and are covered under a health insurance plan. 

However, while making a claim, it is imperative to understand what all is covered and what isn’t covered under your health insurance policy. A few insurance providers have given a bunch of inclusions and exclusion for the treatment of COVID-19. It is essential for you to know these terms and conditions so that there is no disarray while filling a request for the claim.

Moreover, there are designated Covid hospitals in different states. For instance, Delhi government have declared list of dedicated COVD 19 hospitals that includes GB Pant Hospital, Rajiv Gandhi Super Speciality Hospital, Lok Nayak Hospital, Guru Tegh Bahadur Hospital, Deen Dayal Upadhyay Hospital and Dr Baba Saheb Ambedkar Hospital amongst others. In Mumbai also there are dedicated hospitals offering COVID 19 treatment such as Breach Candy, Saifee, Wockhardt, Global and more.

Although your health insurance policy cover expenses incurred for COVID 19 treatment, but it is imperative to know and understand the terms and conditions mentioned in the health insurance policy. You can visit BimaKaro and speak to their insurance experts to understand the policy clauses and opt for the right health insurance policy.

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