Your health insurance policy might not cover coronavirus in these situations

Health insurance and coronavirus

With the number of coronavirus cases in India crossing the 100 marks, it is no surprise that inquiries about insurance policies for the viral infection are on the up too. Currently, in India, tests for Covid-19 are free. However, hospitalization charges must be borne by the patients, unless of course, they are covered under a standard health insurance policy.

Most health insurance policies in India are providing cover for coronavirus. In fact, insurance startup Digit even launched a coronavirus insurance product, it allows a person to insure themselves for a sum assured ranging from Rs 25,000 to Rs 2 lakh. However, there are certain scenarios that, if you find yourself in, will not cover the virus. Your claim will also be limited by the maximum sum insured by your policy. Here are those situations.

Case 1: If you are not hospitalized for minimum of 24 hours

Health insurance claims due to coronavirus will be payable only if you have been hospitalized for at least 24 hours. Otherwise, your policy may not cover the claim because most of the indemnity type health insurance policies (mediclaim) in India do not cover outpatient treatment.

Now, in case you have purchased a new health insurance policy, then here are the scenarios under which claim for treatment of this viral disease may not be covered.

Case 2: If you are opting for a planned treatment

If you have been suffering from severe respiratory or related diseases such as coughing, breathlessness, flu over the past few days and you plan to get treatment for it, then your claims under a regular indemnity type or coronavirus-specific health insurance policy might not get settled. Even if this results in the detection of symptoms of coronavirus, your policy might not cover it.

Hence, any treatment previously planned, i.e. before purchasing policy, under a newly purchased health insurance/coronavirus insurance policy is not covered.

Case 3: If you contract the disease during the waiting period

A waiting period refers to a pre-fixed time period starting from the date of purchase of the policy. In a majority of health policies, coverage of many diseases starts only after the waiting period. The insured will not get a claim filed for treatment of disease within the policy waiting period if treatment is excluded from the waiting period. Typically, most policies exclude several kinds of treatment in the waiting period of the policy.

The special cover launched by Digit also has a waiting period of 15 days. If you are diagnosed with the coronavirus disease/infection within this period, your policy will not cover it.

Case 4: You or family member recently visited victim countries

If you are travelling from a coronavirus affected country and are diagnosed positive, you will be covered under regular indemnity health insurance policy, provided you are being quarantined in India. However, the special coronavirus insurance policy does not cover people who have travelled to coronavirus affected countries such as China, Hong Kong, Macau, Taiwan, Italy, Kuwait, Japan, Singapore, South Korea, Thailand, etc. The same applies if you contract the infection from a family member who travelled to these locations.

News Source: Economic Times, Url:

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