The insurance coverage regulator – Insurance coverage Regulatory and Growth Authority of India (Irdai) – has finalised the rules for traditional covid well being merchandise after a sequence of draft rules had been issued by it to the insurance coverage corporations prior to now one month.
Non-life insurers, which embrace standalone well being insurers have to supply two merchandise – Covid Normal Well being Coverage (Corona Kavach) and Covid Normal Profit primarily based well being coverage (Corona Rakshak) to customers from July 10.
Earlier, the regulator had toyed with concept of an indemnity-based product from June 15 particularly for Covid-19, however later the draft tips had been revised and it requested insurers to supply a benefit-based product as an alternative for Covid-19 by June 30. The regulator then revised the draft tips for the third time and requested insurers to offer two merchandise as an alternative of 1 – a profit primarily based and the opposite, indemnity primarily based.
Within the ultimate tips, the Corona Kavach coverage will include a base cowl that will likely be supplied on an indemnity foundation and an non-compulsory cowl that will likely be made obtainable on a profit foundation. This indemnity coverage will cowl the hospitalisation bills incurred by the insured particular person for the therapy of Covid-19 on constructive analysis. All prices referring to room, boarding, nursing bills, medical session together with telemedicine, consumables similar to PPE kits and intensive care unit will likely be coated underneath the coverage.
It should additionally embrace the price of therapy for every other co-morbidities, together with pre-existing comorbid situations together with the therapy for Covid-19.
The regulator has not set a ceiling on the price of room and ICU within the coverage. Nevertheless, a most of Rs 2,000 will likely be coated so far as expense on ambulance is anxious. Furthermore, dwelling care therapy may also be coated by insurers in case the insured particular person avails therapy at dwelling for a most of as much as 14 days.
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The non-compulsory cowl underneath Corona Kavach pays 0.5 per cent of the sum insured per day for every 24 hours of steady hospitalisation for therapy of Covid-19 following an admissible hospitalisation declare underneath this coverage. The profit shall be payable for a most of as much as 15 days throughout a coverage interval in respect of each insured particular person.
The minimal sum insured for Corona Kavach will likely be Rs 50,000 and it will probably go upto Rs 5 lakh.
The coverage will include a tenure of three and half months, six and half months and 9 and half months, together with ready interval and there will likely be a single premium.
The Corona Rakshak coverage will likely be a normal profit primarily based coverage the place a lump sum profit equal to 100 per cent of the sum insured shall be payable on constructive analysis of Covid-19, requiring hospitalisation for a minimal steady interval of 72 hours. It should include a minimal sum insured of Rs 50,000 and have a most sum insured of Rs 2.5 lakh.
The Rakshak coverage additionally comes with a tenure of three and half months, six and half months and 9 and half months, together with ready interval and there will likely be a single premium.
Whereas the coverage wordings and the advantages obtained will likely be uniform throughout all insurers, the pricing of the product has been left to the insurers. Specialists say, the usual product will likely be cheaper than different complete well being merchandise and the profit primarily based Covid-19 product will likely be priced larger than the indemnity product.
“The hallmark feature of these products is the uniformity of the policy wordings across the market. Claims management will be an important aspect of these products and insurers are working closely with the General Insurance Council to bring some rationalisation in the treatment costs”, mentioned Milind V Kolhe, Chief Underwriting and Reinsurance Officer, Bharti AXA Basic Insurance coverage.
“These policies will cater to people who currently don’t have a holistic health insurance policy and are looking to cover themselves against Covid-19. The policy coverages, terms & conditions are standard across insurers; the USP would be wide network of hospitals for cashless facility”, mentioned Rashmi Nandargi, Head – Retail Well being Underwriting, Bajaj Allianz Basic Insurance coverage.
Explaining the logic behind two merchandise, consultants mentioned that if anybody had a standard well being product, they may take the benefit-based product and on testing constructive, they’d get a lump sum quantity. The benefit-based product could possibly be taken as a supplementary product. Nevertheless, if one didn’t have a product, then choosing the indemnity primarily based product made sense.