Even though for quite some time India seemed to be immune to the coronavirus outbreak as it sped to nations globally, eventually India too fell in its clutches. The number of patients getting tested positive is scaling up every day. People are being urged to take every possible precaution such as observing personal hygiene and avoiding mass gatherings. At the same time, it is important to be prepared for the possibility of contracting coronavirus. And in such a case, you will need your health insurance policy.
The first question you might be asking is, whether your health insurance policy will cover coronavirus or not. The answer is yes, it will.
But there are a few terms and conditions. There are some scenarios under which your claim for the sum assured might be rejected. Read on to know all about it-
1. Hospitalization for 24 hours
Diagnosis of coronavirus alone is not enough for claim settlement. Insurers will only pay you the sum assured if you have been hospitalized for at least 24 hours. Since most insurance policies in India do not cover the Out Patient Department Treatment, they may refuse to pay up without hospitalization.
2. Being branded as a pandemic or epidemic
If the World Health Organization labels coronavirus as a ‘pandemic’ (which has already happened) or as an epidemic by the Indian Government, then insurers can decide to not honour the medical claim. A pandemic is an illness that has spread globally and affects millions. Everyone is at risk of contracting a pandemic illness. And that is why insurers are likely to reject insurance claims.
But there are some insurance plans provided by public sector banks that have factored in the danger that COVID-19 poses to the lives of Indians and hence decided not to reject claims at all even if coronavirus is an epidemic. They are planning to extend as much help as possible to the people of this country at their hour of need.
If you are purchasing a healthcare policy now, make sure to check the terms. Many policies cover pandemics and epidemics and it is wise to choose such plans. COVID-19 may not be the last case of global infection. Investing in a health policy that extends coverage to such illnesses may be a blessing to you and your family in the future.
3. Flu as a pre-existing illness
Just as your claim would be rejected if you purchase a policy with pre-existing illness and seek the sum assured for the treatment of the same, contracting the flu prior to purchasing the health care policy will be grounds for claim rejection.
Suppose you have been exhibiting the signs of the common cold or flu (which are exactly the same as those of coronavirus) for a few days. And it is in this juncture that you decide to purchase a health plan. If the results of diagnostic tests show that your symptoms are the result of coronavirus and not the flu, your insurer may refuse to pay up. Your insurer will think that you purchased the policy just because you feared you had contracted the dreaded coronavirus.
4. You develop the coronavirus infection during the waiting period
Every health policy has a waiting period. If you are diagnosed with any illness during this window, your insurance plan will not pay for the treatment of it. This law applies to coronavirus as well.
5. Travelling to a coronavirus-affected country
If you contracted the virus when you had been abroad in a country under the grips of coronavirus, then filing a claim will be no good, as it will be rejected. Insurers will look into your travel history. Only if you develop the infection in India, will your policy pay you the sum assured.
If you have any queries, speak to a representative of your insurer. And don’t forget to adopt every precaution to ensure that you don’t contract coronavirus in the first place.