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Need to Claim Health Insurance for COVID-19? Find Out How

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Published on February 16, 2022. EST READ TIME: 3 minutes

It’s true that countrywide vaccination drives have helped us deal with the pandemic better than before. But the coronavirus is still mutating, which means, no one knows what kind of danger it might pose in the future. Hence, having health insurancewith coronavirus cover is essential. That is because, in case you get affected at any point of time and require hospitalisation or extensive treatment, the policy can take care of your expenses. However, just buying the policy is not enough. You need to know and understand all the terms and conditions as well to avoid any hassle while filing a claim, if the need arises. Now, find out how to make a successful claim request if you get infected by the coronavirus.

Basic information

Most standard health insurance policies cover the treatment costs, that is, pre and post hospitalisation expenses related to coronavirus. If you already have an active health plan, it will cover for coronavirus along with other diseases and ailments. There’s no need to buy a separate cover for it. But if you don’t have a health insurance plan and buy after being tested positive for COVID-19, then the expenses incurred on its treatment will not be covered.

Now, if you want a coronavirus specific insurance coverthat is customised to cover only COVID-19 related treatment, there are 2 plans which have been mandated by the IRDAI – Corona Kavach and Corona Rakshak. Corona Kavach is an indemnity-based plan (your hospital bills will be reimbursed) and Corona Rakshak is a benefit-based plan (you will be provided a lumpsum amount, that is, you will be given the entire sum insured). These COVID only policies are short-term plans and will not be valid after you make a claim. The premium of these plans needs to be paid only once at the time of purchase.

How to claim for coronavirus?

If you have tested positive for COVID-19 at any authorised lab of ICMR and require hospitalisation for the treatment, there are two ways in which you can file a claim - cashless or reimbursement. You can avail cashless facility if the treatment is done at any of the network hospitals of the insurance provider. In that case, the bills will be settled by the insurance provider directly with the hospital. In case of reimbursement claim, you can receive treatment at any hospital of your choice, pay the bills and get the bills reimbursed from the insurer after discharge from hospital.

When will you not be able to register a claim?

There are certain situations where you cannot register a claim:

• If you buy health insurance after testing positive for the virus, you cannot claim for the expenses.

• If you have not been hospitalised for at least 24 hours.

• If you are under medication for cough, flu or any COVID-19 symptoms and plan to get treated to find out if you have been infected with the virus, then you will not be covered if you test negative.

• If you or any of your family member has a travel history to high-risk nations and you get infected after being in close contact with them, your claims may get rejected.

Conclusion

Not all medical expenses are covered by the coronavirus health insurance policy. So, if you have an existing insurance cover, it’s advisable to check with your insurance provider if COVID-19 is covered or not. Knowing what claims will get rejected is also important so that you are well prepared.

Disclaimer: The above information is for illustrative purpose only. For more details, please refer to policy wordings and prospectus before concluding the sales.

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