Few Group health insurance policies have a clause that prevents them from settling pandemic or epidemic related claims. Covid-19 was declared a pandemic by the World health organization which means that most group health insurance policies would not settle the covid-related claims. The coronavirus has made a serious impact on the lives of Indians and the insurance regulator in India, Insurance regulatory and development authority of India has directed all the insurance companies to settle the covid-19 claims even though it is declared a pandemic.
The Government of India has even asked the organizations working during the pandemic period to take a covid specific health insurance policies to safeguard their employees from corona related hospitalization expenses. As per the direction of IRDA, insurance companies have introduced covid specific health insurance policies known as Corona Rakshak and Corona Kavach which cover people on individual as well as group levels. The government of India has made it mandatory to avail Group health assure policy which covers the covid related hospitalization expenses for those companies working during the pandemic period.
Corona specific policies are introduced by the insurance companies and cover the inpatient treatment related to coronavirus which requires basic hospitalization. The maximum sum insured under the corona specific health insurance policies was Rs. 2 Lakhs which was limited and the cost of corona treatment was way above this amount. Most of the health insurance policies which are already taken by the customers also cover the corona related expenses up to the sum insured limit available under the policy.
The group health insurance policies also cover the home care treatment expenses. All the covid claims are covered irrespective of the pre-existing conditions. There are no sub-limits on the room rent, doctor’s fees, medicines, diagnostics, and other related charges. All the consumables such as PPE Kit, Gloves, etc. are covered under the corona specific health insurance policies. The group health insurance policy covers the testing and other charges if the insured is hospitalized due to Corona and the treatment is taken for the same. The insurance company would not reimburse the cost of covid-19 vaccine under the group health insurance policy as vaccination for pandemics is not covered under any group health insurance policy.
Organizations are reimbursing the cost of vaccine or arranging mass vaccination programs to vaccinate all their employees against covid-19 but the group health insurance offered by the organizations do not reimburse the covid-19 vaccine expenses. The testing charges are covered under the group health insurance policy subject to the customer availing of in-patient or at-home treatment after testing positive for the coronavirus. The testing done as a part of the treatment would be covered under the group health insurance policy subject to the terms and conditions. The insurance regulator has made it clear that the insurance companies should cover all the costs related to the treatment for coronavirus.
It is advisable to know completely the coverages and exclusions in the group health insurance policy before taking one. For more information on the coverages under the group insurance please book a call with Ethika insurance broking.