Is COVID19 expense covered in my insurance?


Health insurance policies cover all kinds of respiratory diseases, therefore they also cover corona virus, provided the affected person doesn't have COVID-19 at the time of purchasing the policy.

The Insurance cover products will include all the basic coverage as well. Hence, all covers such as in-patient treatment, pre-hospitalisation, post-hospitalisation and ambulance cover provided in particular health policy offers will also be available for corona virus as well.

Generally, diagnostic expenses are not covered by health policies. However, diagnostic expenses would be covered under pre-hospitalisation extension if in case the patient is tested positive and hospitalised. According to experts, in case, the policy covers OPD (outpatient department) expenses, then the cost of diagnostics will be covered based on the policy terms.

Certain limitations have been imposed on the corona virus infection as well.

If you have been already suffering from a respiratory infection in the previous four weeks, then your mediclaim under a basic health insurance policy or a corona virus specific insurance policy may not be settled.

Also, you might be unable to register a claim under the following conditions:

  • If you and your family members have recent travel history to any of the worst affected countries
  • If you are hospitalized for lesser than 24 hours
  • If you have pre-existing cold-like symptoms and planned to undergo treatment
  • If the insured contracts the disease anytime during the policy waiting period

You can opt for a cashless claim facility or reimbursement facility depending upon the policy terms.

For cashless claim, you may inform the necessary third-party administrator (TPA) in the hospital and can get admitted to a network hospital and receive the necessary treatment. Moreover, in cashless claims, a patient is not required to pay any incurred expense for the treatment of an illness.

Whereas in the reimbursement process, you can get treatment in a hospital of our choice after you inform the insurer and payment of incurred bills. All these bills will later be reimbursed to the policyholder up to the sum insured after proper verification from the insurer. In any form of insurance, there are terms and conditions, exclusions, or waiting periods based on which claims are settled or rejected.

Many insurance companies have introduced insurance products that cover individuals specifically for corona virus.

Go Digit, built under Digit Health Care Plus is an insurance product which covers individuals on the detection of corona virus, wherein 100 percent sum is insured in the form of a lump sum. If quarantine has been advised to the policyholder, he is paid 50 percent of the sum insured in the form of a lump sum. You can choose from multiple sums insured options anywhere from Rs 25,000 up to Rs 2 lakh.

Star Health and Allied Insurance have launched Star Novel Corona virus Insurance Policy which covers all those who test positive for COVID-19. It provides a lump-sum payment to any individual insured between the ages of 18 to 65. The policy doesn't have any exclusion such as international travel history. It is available in two sum insured options of Rs 21,000 and Rs 42,000 for premiums of Rs 459 plus GST and Rs 918 plus GST, respectively.

'COVID-19 Protection Cover’ of ICICI Lombard will also pay 100 percent of the sum insured to the policyholder if they are tested positive for corona virus, irrespective of hospitalisation expenses.