Coronavirus (COVID-19) and your Health and Life Insurance Coverage in India

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Covid -19 or corona virus is spreading rapidly all over the world and India  population is worried on repercussions of corona virus and its treatment.

As on March 18, 2020 , number of cases reported in India are 148 with more than 31 cases reported in Maharashtra . Still the course of treatment is not clear and patients may need to be admitted under Isolation ward or may need ventilator support in ICUs. Cost of treatment may be higher and all health insurance policy holders are sceptical whether claims will be admissible as course of treatment is still vague. Moreover, WHO has declared Covid -19 as pandemic and Indemnity based health insurance has general exclusions of pandemic or epidemic.

Insurance Samadhan

Health and Life Insurance Coverage for Coronavirus in India

Insurance Samadhan tried to do initial research and have observations regarding Coronavirus Insurance plans in India as detailed below:

  1. Life Insurance: At the outset, life insurance is not an indemnity product and has no exclusion of epidemic or pandemic. Hence all life insurance claim are admissible without any exclusion.
  2. Critical Illness: Covid -19 does not fall under critical illness hence it will not apply. However, Covid 19 may cause damage to kidney which is covered under critical illness. In case kidney is damaged and patient survives for 30 days then critical illness claim is admissible.
  3. Health Insurance: IRDA has given clear instructions to expedite claims of carona virus and all Health Insurers have agreed to abide and have made special provisions to pay claims if patient is admitted for over 24 hours. However, health insurers have all legal right to refuse to pay as carona virus is declared pandemic. All indemnity products are subject to exclusions provided in Terms and Conditions of Policy Contract. Which means Insurers would take decision on the basis of magnitude of problem. There will not be any hesitation to settle claims in early stages but they may change the stand if corona virus spreads and reach to unmanageable magnitude.
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Insurance Samadhan spoke to many insurers ad they have the opinion to wait and watch the spread before taking any decision. Till now, they are willing to pay claims as per guidelines of IRDA.

Public should not be worried as initial treatment is being done at designated government hospitals only and insurance cover may not be needed. IRDA may also come with their directions post declaration of Pandemic.

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Insurance Samadhan

Shailesh Kumar

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