Introduction

Corona Kavach Policy is a health insurance policy meant for Covid-19 related treatment expenses only. Last year when COVID-19 had just started, Insurance Regulatory and Development Authority of India (IRDAI) or Insurance regulator had directed all insurers to come with a specific short term health insurance policy to cover Covid care treatment expenses. So all insurers have come up with Corona Kavach and Corona Rakshak Policy.

Image explaining Corona Kavach Policy using symbols

Most importantly, both the policies cover treatment for COVID-19 arising out of co-morbidity (i.e. having pre-existing conditions like heart problem, diabetes etc ).

Why should you buy Corona Kavach Policy ?

You might wonder why is it beneficial to buy a Corona Kavach policy when you already have health insurance. In a nutshell, Corona Kavach is a single premium limited period policy without any lifelong renewable benefit. This is Indemnity based policy (i.e. if an individual is tested positive for Corona Virus then the insurance company will pay upto the medical cost associated with treatment of the disease maximum upto the sum insured opted for).

Most important condition for the policy to trigger is the patient should be detected covid positive and the reports have to be from a govt authorized diagnostic center.

Who offers the cover? As per IRDAI guidelines, all general and health insurance companies can offer this cover. But currently only 3 insurers : New India Assurance , National Insurance and SBI General Insurance
Who can be covered under the policy? Proposer /legally wedded Spouse /Parents/ Parents In law and dependent children upto 25 years of age
Type of policy Individual or family floater
Age band 18 years to 65 years
Sum Insured Rs 50,000 to Rs 5 lakhs
Policy Period 3 ½ Month / 6 ½ Month / 9 ½ Month
Waiting period 15 days (i.e. if Corona Virus is detected within the first 15 days after the policy start date , it is not covered) .The coverage starts from the 16th day.
Minimum hospitalization required 24 hours to claim under policy and the claim will be paid upto the actual cost of medical expenses or the sum insured whichever is lower
Type of claims Cashless as well as reimbursement
Geographical Limits for coverage India

What is covered under Corona Kavach Policy?

  • COVID hospitalization cover
  • Road Ambulance charges upto Rs 2000/- for COVID related claim
  • Home care treatment expenses
  • AYUSH Treatment
  • Pre and post hospitalization treatment (15 days prior to hospitalization and 30 days after hospitalization)
  • Hospital Daily cash is an optional cover

If a person is admitted to a hospital then the following charges related to COVID-19 treatment are covered

  • Room charges, doctor charges, nursing charges.
  • ICU charges
  • Blood, oxygen, plasma, ventilator charges.
  • Medicines related to COVID-19
  • Diagnostic charges.
  • Cost of PPE kits.

What is covered under AYUSH Treatment ?

Treatment taken under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during the Policy Period up to the limit of sum insured for COVID 19 treatment taken in Govt approved AYUSH hospital will be covered.

What is home care treatment cover in Corona Kavach Policy?

When a person is tested covid positive and which in normal course would require care and treatment at a hospital but is actually taken at home maximum up to 14 days per incident provided that:

  • The Medical practitioner or doctor has advised the patient to take treatment at home . Also there has to be an active line of treatment which is monitored by the doctor.
  • The daily monitoring chart and details of COVID-19 treatment has to be signed by the treating doctor on regular basis.
  • If treatment is taken through a non -network provider then approval from the insurer is required before treatment.

What expenses are covered under homecare treatment for COVID-19:

  • Consultation charges of the medical practitioner
  • Nursing charges related to medical staff
  • Cost of medicines
  • Medical procedures limited to parenteral administration of medicines
  • Cost of Pulse oximeter, Oxygen cylinder and Nebulizer.

What is not covered under Corona Kavach Health Insurance Policy ?

  • Investigation and Evaluation except for COVID
  • Rest Cure, rehabilitation and respite care
  • Unproven treatment
  • Any claim prior to policy start date
  • Any expenses incurred on daycare or OPD treatment
  • Treatment taken outside of India
  • All covers under this Policy shall cease if the Insured Person travels to any country placed under travel restriction by the Government of India.
  • Testing done at a diagnostic centre not approved by Govt of India

Any treatment taken apart from COVID-19 is not covered under Corona Kavach.

Corona Kavach Premium chart is as below:

Policy term Base cover for Rs 50,000 (0-35 years) Base cover for Rs 500,000 (56 years and above)
3.5 months 447 3378
6.5 months 596 4504
9.5 months 745 5630

Note: This is the premium range given for individual insured for understanding purposed, kindly check with the insurer for the age wise premium details .

Why is it beneficial to buy Corona Kavach Policy?

  1. Affordable premium . The premium range is from Rs 500 to Rs 8000 for a family floater.
  2. The cost of PPE kit will be reimbursed in full.
  3. All expenses related to room rent will be covered in full.
  4. Covers treatment for COVID-19 arising out of co-morbidity (i.e. having preexisting conditions like heart problem, diabetes etc )..
  5. AYUSH Treatment is covered
  6. Home care treatment is covered
  7. Hospital Daily cash is covered (0.5% of the sum insured) upto 15 days of hospitalization i.e. for INR 5 lakhs cover ; Rs 2500 per day will be the cover.

Are there any tax benefits under Corona Kavach health insurance policy?

The premium paid is considered as eligible for tax benefits according to section 80D of the Indian Income Tax Act. Check with yout financial advisor or tax consultant on the specific limits.

How to file a claim under the Corona Kavach Policy?

You can claim either through cashless process by getting admitted in a network hospitalization or through reimbursement process if you get admitted in non -network hospital.

Note: Any claims taken for treatment of COVID-19 only in India stand covered.

Claims documents under Covid Kavach Policy for hospitalization:

  1. Duly filled and signed Claim Form
  2. Copy of Insured Person’s passport, if available (All pages)
  3. Photo Identity proof of the patient (if insured person does not own a passport)
  4. Medical practitioner’s prescription advising admission
  5. Original bills with itemized break-up
  6. Payment receipts
  7. Discharge summary including complete medical history of the patient along with other details.
  8. Investigation reports including Insured Person’s test reports from Authorized diagnostic centre for COVID
  9. OT notes or Surgeon’s certificate giving details of the operation performed, wherever applicable
  10. Sticker/Invoice of the Implants, wherever applicable.
  11. NEFT Details (to enable direct credit of claim amount into bank account) and cancelled cheque.
  12. KYC (Identity proof with Address) of the proposer, where claim liability is above Rs 1 Lakh as per AML (Anti Money Laundering ) Guidelines
  13. Legal heir/succession certificate, wherever applicable
  14. Any other relevant document required by Company/TPA for assessment of the claim

Claims documents under Covid Kavach Policy for home care treatment expenses

Duly filled and signed Claim Form

  1. Copy of Insured Person’s passport, if available (All pages)
  2. Photo Identity proof of the patient (if insured person does not own a passport)
  3. Medical practitioners’ prescription advising hospitalization
  4. A certificate from medical practitioner advising treatment at home or consent from the insured person on availing home care benefit.
  5. Discharge Certificate from medical practitioner specifying date of start and completion of home care treatment.
  6. Daily monitoring chart including records of treatment administered duly signed by the treating doctor is maintained.

How to buy the policy online?

Frequently asked questions (FAQ) related to Corona Virus (COVID 19)

Is there any waiting period applicable for claims under COVID-19 health insurance plans?

Currently there are two policies available in the market related to COVID-19. One is Corona Kavach and other is Corona Rakshak. Both the policies have a waiting period of 15 days. (It means if you have purchased a policy on 1st June 2021, then any claims arising out of treatment for COVID-19 upto 15th June 2019 does not stand covered. If the person is infected after 15th June 2021 and treatment taken thereafter stands covered under the policy)

Does health insurance in India cover any kind of diagnostic charges like MRI, X-Ray or any other body scans?

Health Insurance policies in India are designed to cover cost of treatment related to the ailment for which the insured is admitted to the hospital. The policy includes the costs related to diagnostics as well which form part of the treatment. So costs associated with MRI, X-Ray or any scans related to the line of treatment will stand covered under the policy. For detailed description related to what is covered under your health insurance policy, you can read the blog : Health Insurance Policies in India

Is health insurance for the COVID-19 Coronavirus disease available in India?

Yes , the health insurance policies in India cover costs related to any ailment for which active line of treatment is given and it applies as well in case of COVID-19 or Coronavirus . Apart from that we have specific policies like Corona Kavach and Corona Rakshak to provide cover specificially for Corona virus.

For details about what is covered with respect to COVID-19, you can listen to our shows in Hindi on Bimacast and on Insurecast in English. These podcasts will be launched shortly on gaathastory network.

Difference between a Corona Kavach and Corona Rakshak Coronavirus health insurance?

Corona Kavach is an Indemnity based policy which provides cover against treatment taken for Coronavirus or COVID-19 while Corona Rakshak policy is a benefit policy which pays the sum insured opted for when a person is detected with COVID-19. The key covers under both the policies is as below:

Is Coronavirus treatment covered if you already have an active health insurance policy? or Will My Health Insurance Plan Cover the Medical Expenses Related to Coronavirus?

Health Insurance Policy is normally covers any ailment for which treatment is required to be taken in hospital. The minimum period required for hospitalization is atleast 24 hours and there should be an active line of treatment. Hence if a person is taking treatment for COVID-19 which requires minimum 24 hours in hospitalization then the policy will pay the costs associated with the treatment. The policy will also pay the expenses associated with pre-hospitalization as well as post- hospitalization related to COVID-19. In a normal policy the pre and post hospitalization expenses will be for 30 days and 60 days respectively.

Can I avail cashless treatment facility under a COVID-19 health insurance policy?

Cashless treatment can be availed under COVID-19 health insurance policy (i.e. Corona Kavach) if your treating hospital is among the empaneled hospital with your insurer or the Third Party Administrator. For Corona Rakshak Policy, the claim will also be on reimbursement basis.

If I already have a health insurance policy in place, does it make sense to buy a Corona Kavach Policy?

It is beneficial to have an additional Corona Kavach policy apart from your health insurance policy . Advantages of Corona Kavach is as follows:

Corona Kavach will provide treatment if the person is admitted to hospital due to Corona at an affordable premium.

Since 15-20% of the cost pertaining to COVID-19 is related to PPE kits which is not covered under the normal health insurance policy, but covered under Corona Kavach Policy

Comorbidity condition is excluded under normal health insurance policy but covered under Corona Kavach(i.e. if you have pre-exisiting diseases like heart ailment, diabetes or blood pressure and if you are diagnosed with COVID-19 then a normal health insurance policy will reject the claim under the comorbidity clause ) which is not the case if you buy Corona Kavach Policy.

I had purchased a Corona Kavach policy last year but this year when I had gone for renewal, the insurance company did not renew the policy- what should I do?

Though IRDAI mandated all insurers to issue Corona related specific policies, very few insurers are offering Corona Kavach especially due to the second wave insurers are cautious. Currently i.e. as of 7th June 2021, only three insurers New India Assurance, National Insurance and SBI General Insurance are offering these covers in the market and you can ask them if they can extend the policy. Since coverages are the same across all companies, renewing the policy with different insurer should not be a challenge.

get in touch with your insurer for detailed list of documents required to submit a claim.

Hope this article was able to address the benefits associated with Corona Kavach Policy. For any queries related to insurance matters please write to [email protected]

Cover Image: andremsantana on Pixabay

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