Know all about eKYC for buying your Insurance policy during Lockdown

Ramesh was looking to buy insurance but with the lockdown, he was unable to meet his agent and buy the policy. Then he found out about online insurance plans and was delighted to know that he can easily buy an insurance policy with eKYC. You can too because now insurance plans are issued through eKYC. Let’s explore how!

The world has gone digital and online transactions are ruling the roost. Even when it comes to financial transactions, the markets have gone digital as you are allowed to buy mutual funds or open a bank account in a paperless format using eKYC norms. Under the eKYC norms, your identity is verified through an Aadhaar based process wherein you can provide your eAadhaar details and complete the transaction. While the concept of eKYC was acceptable in banking and mutual fund transactions, now the insurance segment has also embraced this concept making insurance policies completely paperless.

eKYC in insurance

The Insurance Regulatory and Development Authority of India (IRDAI) has allowed online, paperless, Aadhaar based verification process for buying insurance policies online. This would eliminate the need of visiting the branch of the insurance company or meeting with an insurance agent to buy the insurance policy and submit your documents. You can simply buy the policy online and verify your credential through the eKYC norm. This would benefit both customers and insurance companies as –

  • The purchase process would become simple
  • No lengthy documentation would be needed to be physically submitted
  • It would promote the Digital India initiative taken by the Government and would make customers more self-reliant

The move for eKYC norm is also relevant in recent times when Coronavirus pandemic has forced individuals to stay at home and practice social distancing. Since insurance policies would become paperless, individuals would be able to invest in a suitable insurance policy right from the comforts of their homes without having to step out to complete the documentation. Moreover, since documents would not be needed to be submitted at the insurer’s office or with the insurance agent, social distancing norms can be easily followed and policies can be bought even in the lockdown. However, if income proofs are needed or when there is a need for medical reports of pre-entrance medical check-ups, these documents would still have to be submitted physically.

Currently, selective insurance companies, both in the life and non-life segment, have accepted the eKYC format for selling insurance policies. Let’s have a look which companies are these –

Life insurance companies 

  1. Bharti AXA Life Insurance Company Limited 
  2. Bajaj Allianz Life Insurance Company Limited
  3. HDFC Life Insurance Company Limited
  4. Exide Life Insurance Company Limited
  5. IndiaFirst Life Insurance Company Limited
  6. ICICI Prudential Life Insurance Company Limited
  7. PNB MetLife Life Insurance Company Limited
  8. Max Life Insurance Company Limited
  9. Future Generali India Life Insurance Company Limited
  10. SBI Life Insurance Company Limited
  11. Aegon Life Insurance Company Limited
  12. Reliance Nippon Life Insurance Company Limited
  13. Aditya Birla Life Insurance Company Limited
  14. Shriram Life Insurance Company Limited
  15. Kotak Mahindra Life Insurance Company Limited
  16. Pramerica Life Insurance Company Limited
  17. IDBI Federal Life Insurance Company Limited
  18. Star Union Dai-ichi Life Insurance Company Limited
  19. Canara HSBC OBC Life Insurance Company Limited
  20. Edelweiss Tokio Life Insurance Company Limited

General insurance companies

  1. Acko General Insurance Company Limited 
  2. Kotak Mahindra General Insurance Company Limited
  3. Religare Health Insurance Company Limited
  4. Future Generali India Insurance Company Limited
  5. Manipal Cigna Health Insurance Company Limited
  6. Royal Sundaram General Insurance Company Limited
  7. HDFC Ergo Health Insurance Limited
  8. SBI General Insurance Company Limited
  9. HDFC Ergo General Insurance Company Limited

So, the next time you want to buy insurance policies from any of the above-mentioned companies, opt for the eKYC norm of verification and buy the policy online in a contactless manner.

Now you don’t have to pay a huge premium for long term comprehensive motor insurance plans

Rohan bought a new car last month but he was concerned about the high premium which was being asked for a long term comprehensive car insurance policy. The premium was straining his budget and he did not know what to do. This is when he found that long term comprehensive policies have been discontinued by the IRDAI. He was relieved to find a considerable reduction in his premium. Do you know the changes IRDAI has made in long term comprehensive motor insurance plans?

The insurance segment is dynamic and the Insurance Regulatory and Development Authority of India (IRDAI) periodically makes changes in the structure and benefits of insurance policies. One such change was made in the year 2018 when IRDAI introduced compulsory long term motor insurance policies for cars and bikes. According to the IRDAI mandate, cars and bikes bought on or after 1st September 2018 had to carry a compulsory 3 year and 5-year third party coverage respectively. Own damage cover, however, was allowed to be offered either for 3/5 years with the third party cover or for one year in a bundled policy.

However, recently, IRDAI has withdrawn this mandate of having a long term own damage cover on cars and bikes. As per the latest changes made by IRDAI, third party coverage would be offered for 3 and 5 years for cars and bikes respectively. However, the own damage cover would be available only for one year. Thus, insurance companies would now have to sell the bundled car and bike insurance policies with long term third party cover and annual own damage cover.

Why the need for change?

In its circular where IRDAI withdrew the concept of long term own damage cover, various reasons were cited for the withdrawal. These reasons included the following –

  • The concept of long term comprehensive cover was not very feasible for policyholders who had to shell out considerably large amounts of premium when buying the policy
  • The long term comprehensive plans were not very much in demand as policyholders usually opted for bundled policies to reduce their premium outgo
  • In many cases where policyholders were unaware of the availability of bundled plans, long term comprehensive plans were miss-sold to them by insurance agents and distributors which was unethical
  • In a long term comprehensive plan, policyholders were tied up with one insurance company for the given tenure without having the flexibility of changing insurers
  • The no-claim bonus offered under long term comprehensive plans were not uniform across insurance companies. The bonus was allowed once at the time of renewal after the long term period was over. This resulted in a low bonus for policyholders who can otherwise claim no claim bonus every year on renewals. Since the bonus was low, policyholders lost on the discount available to them making long term plans unfavourably for them

What does the change mean for you?

If you have bought a new car or bike on or after 1st September 2018, you don’t have to buy a long term comprehensive policy on your vehicle. You would have to buy a bundled policy where the own damage cover would be allowed on an annual basis while the third party cover would continue long term. You can benefit from this move in the following ways –

  • Your upfront premium outgo would reduce
  • You can claim a higher no claim bonus as you renew the own damage cover every year
  • You can easily switch insurance companies if you are unsatisfied with your present insurer or if you find lower premium rates with another

So, your vehicle insurance policies would cost less and you would be able to compare and buy a standalone own damage cover for your vehicle from any insurer. This move would help you afford a motor insurance policy easily making the coverage more popular. Rohan knew that he can easily afford a bundled policy and you can too. So, the next time your motor insurance plan is up for renewal, your premium outgo would be much lower thanks to the new IRDAI regulation.

IRDAI’s New Guidelines for Claims Reported Under Coronavirus

The Coronavirus pandemic is spreading despite the various efforts taken by the Government and the health department. More and more individuals are getting infected even as the lockdown curbs are easing in many parts of the country. If you read the newspapers or watch the news, you would know that the numbers have crossed 3.5 million and they are rising everyday!!

The infection is resulting in hospitalisation and, in certain cases, even death. In case of hospitalisation in a Government hospital, the charges are minimal or even nil. But if you seek hospitalisation in a private hospital, be prepared to face huge costs. Private hospitalisation is expensive and the costs are considerably high making it difficult for an average man to bear. This is where you can call on your health insurance plans. The plans cover the hospitalisation expenses incurred due to COVID infection thereby helping you financially. Moreover, in case of death of an individual, life insurance plans provide the much needed financial assistance to the deceased’s family. 

Because insurance can play an important role in tackling the financial implication of this pandemic, the Insurance Regulatory and Development Authority of India (IRDAI) has issued various guidelines for health insurance companies. These guidelines have been issued in the interests of policyholders so that their health insurance plans can come to their rescue in case of COVID related claims. Here’s what the guidelines say –

For health insurance claims which cover hospitalisation expenses –

  • If the health insurance policy covers hospitalisation, insurance companies should settle COVID-related claims of hospitalisation quickly
  • The medical costs incurred by policyholders during hospitalisation due to the virus and also during the quarantine period should be settled as per the terms and conditions of the policy. Moreover, the settlement should be in compliance with the regulatory framework. In case of home quarantine however, claims would not be admissible.
  • If a claim is being rejected or repudiated, the claim should be thoroughly reviewed by the claim review committee of the insurance company before such rejection or repudiation

Health insurance companies are also encouraged to offer COVID specific health insurance policies which would cover the treatment costs of the virus effectively.

The guidelines were issued by the IRDAI on 4th March 2020 under the provisions of Section 14(2)(e) of the IRDA Act, 1999 and they came into force immediately.

Though there were no specific guidelines for life insurance companies, they were urged by IRDAI to handle their death claims in an expeditious manner so that the family of the policyholders can get claim settlements as quickly as possible. 

These guidelines are proving beneficial for policyholders who are facing the threat of COVID infection. They are being able to make claims in their policies easily. You should also know these guidelines so that you know what to expect from your health insurance plans and how to handle your claims in case of an emergency.

IRDAI asks insurers to Include Telemedicine as Part of Claim Settlement of Policy

Did you know India is the second largest online market in the world with more than 560 million users?

Internet penetration has increased considerably in the past decade and today individuals living even in the remotest part of the country have access to the internet and/or Smartphones. This has allowed individuals to access online services easily without any hassles. So, if you want to buy that trendy mobile phone or groceries, everything is available online. Even in the case of healthcare, consultations through phones and video calls as well as online consultations are steadily becoming popular. Why visit the doctor when the doctor can come to you through your computer or Smartphone? This type of medical assistance is called telemedicine which eliminates the need to physically visit a doctor for medical check-ups.

Before the Coronavirus pandemic became a cause of concern, telemedicine was in its development stage in India with few people actually making use of it. However, with the Government imposed lockdown and the threat of contagion, telemedicine is becoming popular. Understanding the feasibility and benefits of telemedicine, the Insurance Regulatory and Development Authority of India (IRDAI) has advised health and general insurance companies to allow coverage for telemedicine in their policies. Thus, plans covering medical costs, viz. health insurance plans, would now pay claims for costs incurred on treatments and consultations through telemedicine.

Introduction of the telemedicine guideline

The concept of telemedicine is relatively new and so if you have not heard about it, it’s understandable. On 25th March 2020, the Medical Council of India (MCI) issued Telemedicine Practice Guidelines which allowed registered medical practitioners to offer healthcare services through telemedicine. This was done to prevent spreading of Coronavirus through contact. The council reasoned that as healthcare workers and their patients avoid physical contact through the availability of telemedicine, the spread of the virus would be contained. The Board of Governors appointed by the MCI stated different types of technologies available under telemedicine which would allow patients to get medical attention without physical contact. This can prevent the spread of the virus keeping both doctors and patients safe from the illness.

IRDAI’s regulation on telemedicine

Taking the telemedicine guideline forward, the IRDAI directed health and general insurance companies to cover telemedicine as a part of their claim settlement. Given this pandemic, this is a welcome move by the regulator. 

Here’s what IRDAI guidelines stated –

  • Telemedicine would be a part of the insurance claim in health insurance policies if medical consultations are covered under the plan
  • A separate claim is not required to be filed for claiming the cost of telemedicine
  • Any limits or sub-limits applicable to the coverage benefits would continue to apply without any changes

Impact of the regulation

The inclusion of telemedicine in claim settlement is a beneficial move for policyholders. You can now avail telemedicine facilities for your medical issues and get covered under your health insurance plan for the costs incurred. This would help keep you safe from contracting the virus as you can avoid visiting doctors and medical practitioners for consultations.

The pandemic has brought about many changes in people’s lifestyles and you have to adapt to these changes as the disease would take some time to get under control. This measure by the IRDAI is a relief for policyholders as it gives them the freedom to get medical attention without the risk of contagion.

Is your Motor Insurance about to expire? Here’s how you can get discounts on renewal

Did you know that motor insurance plans are compulsory in India? Well, they are! If you want to drive your vehicle in India you need a motor insurance policy on it, thanks to the provisions of the Motor Vehicles Act, 1988. The motor insurance plan comes with specific coverage duration and after the duration comes to an end, you have to renew the policy to enjoy uninterrupted coverage. Timely renewals of motor insurance plans are necessary because if the coverage duration expires, the policy lapses. And do you know what happens then? This lapse stops the coverage and if you are found without a valid motor insurance plan, you would face fines and even legal complications.

Do you want to face fines? Renewing the coverage is so much easier, isn’t it?

Timely renewals also give you another benefit – premium discounts!! Interested, aren’t you? Let’s have a look –

In the current pandemic, with the extended lockdown imposed by the Government, there have been fewer claims over the last couple of months allowing insurance companies to experience good profits on the policies sold. Many companies are sharing these profits with their customers in the form of premium discounts on renewals. Companies are allowing their loyal customers 15% to 20% premium discounts in the renewal premiums when the policy is being renewed on time. So, if you renew your motor insurance policy presently, you can get lower premiums on your comprehensive motor insurance plans.

These premium reductions, due to low claim experience, are being offered by only a handful of insurance companies. Other companies have not reduced their premium rates. However, keeping the current pandemic aside, there are various ways of availing discounts on the premium at the time of motor insurance renewals. These ways are applicable to all motor insurance policies as they do not depend on the insurer’s pricing policies. Let’s understand what these ways are –

  • Use the accumulated no claim bonus

    Comprehensive motor insurance plans allow you a no claim bonus on renewal if you don’t make a claim in the previous policy year. Cool, isn’t it? This bonus allows you a discount on the renewal premium. Moreover, if you don’t make claims for successive policy years, the no claim bonus keeps on increasing. It starts at 20% after the first claim-free year and goes up to 50% after five successful claim-free years. Imagine!! Flat 50% off on renewal premiums. Could it get better? 

    Pro tip: Do not make small claims in your motor insurance policies. Such claims nullify your no claim bonus and you lose the discount. Try and preserve the no claim bonus so that you can get the maximum discount on renewal.

  • Install safety devices in your vehicle

    Safety should be primary to save your life, isn’t it? Well, what if it also gives you discounts? Safety devices prevent the chances of accidents and/or theft and are very beneficial from a claim point of view. If your vehicle is fitted with safety devices it reduces the probability of claims. This earns you a premium discount when you buy or renew your motor insurance policy.

    Pro tip: Ensure that the safety devices have been approved by ARAI (Automotive Research Association of India) so that you can claim a discount.

  • Opt for voluntary deductibles

    Deductibles are the portion of the claim which you pay from your own pockets. Motor insurance plans have a compulsory deductible wherein you have to pay a specific amount of claim mandatorily. Besides this, there is an option of choosing a voluntary deductible which would be an additional amount of claim that you choose to pay. If you choose a voluntary deductible, the insurer’s claim liability reduces. Due to this reduction, the insurance company offers a premium discount when you renew your plan. So, if you are a good driver with a low probability of claims, opt for voluntary deductibles to reduce your premiums.

    Pro tip: Weigh in the amount of premium saved vis-à-vis the voluntary deductible limit you choose to undertake. The savings should outweigh the out-of-pocket claim so that it is economical for you to choose the voluntary deductible.

  • Compare and buy

    You always shop around for clothes, don’t you? Why should a motor insurance policy be any different?

    Motor insurance policies are easily portable and you can change insurers every time you renew your plan. Moreover, there are more than a dozen insurers offering a motor insurance plan for your vehicle. Why not compare? Thus, when renewing, compare the available policies to get the best deal on the premium rate. When you compare you can choose a plan which offers the lowest premiums without compromising on the coverage benefits. This would, therefore, help you reduce your premium on renewal. 

    Pro tip: Always compare the premium rates vis-à-vis the coverage offered. Don’t skimp on the coverage for a reduced premium because then you would incur out-of-pocket expenses at the time of claims.

Reducing your premium on renewals would become easy if you follow the above-mentioned tips. Some insurers are already reducing their premium rates to motivate their customers to renew their plans in this pandemic and economic slowdown. Take advantage of this move to get your motor insurance policy renewed at a lower cost. Moreover, the above-mentioned tips would help in reducing your premiums further making renewals easy for your pockets. After all, a penny saved is a penny gained, right?

IRDAI says: Health Insurance Claims not Contestable After 8-year of Premium Payment

Health insurance claim settlements can prove to be a challenge if the health insurance company contests the claims and rejects or repudiates it. After all, with the policy promising assistance in a medical contingency, claim rejection can be a nightmare!! In such cases, policyholders face huge medical costs and might suffer a financial strain. To safeguard your and other policyholders’ interests, the Insurance Regulatory and Development Authority of India (IRDAI) has, therefore, issued fresh guidelines with regards to health insurance claim settlements. These guidelines are aimed to standardize health insurance terms and conditions and to simplify them for the common man. Let’s find out what IRDAI guidelines state –

IRDAI guidelines on health insurance claim settlements 

According to the latest guidelines issued by the IRDAI, health insurance companies will not be allowed to challenge claims in a policy where premiums for eight continuous years have been paid. Thus, in simpler terms, if you have a health insurance policy which has been continuing non-stop for the last 8 years or above and you have paid regular premiums under the policy, your claims would be settled easily. The insurance company would not be able to challenge claims on such policies given the tenure for which the policy has been in existence. 

The other points highlighted in the guidelines are as follows –

  • Any health insurance policy which does not comply with this new guideline would be modified from 1st April 2021 as and when they are up for renewal. This means that on renewals after 1st April 2021, all health insurance policies would have to comply with the new guidelines.
  • The eight years specified in the guideline would be called the moratorium period. During this moratorium period, health insurance companies can judge whether the claims that you make are genuine or not. However, when this trial period is over, health claims cannot be challenged and the contestability clause would be revoked.
  • The moratorium period would apply to the sum insured originally chosen by the policyholder. If, however, the sum insured is increased, an additional moratorium period would be applicable to the enhanced amount. For instance, if you buy a health plan of INR 5 lakhs on 1st June 2020, the moratorium period would end on 1st June 2028. However, if the sum insured is enhanced to INR 8 lakhs on 1st June 2022, a moratorium on INR 5 lakhs would end on 1st June 2028 but a moratorium on INR 3 lakhs would end on 1st June 2030.
  • Claims would be allowed to be contested only in cases of frauds which the company would have to prove and in the case when a medical cost is specifically excluded from coverage in the policy contract. In the case of frauds, misrepresentation or non-disclosure of material facts, the policy would be considered null and void and the premiums paid by the policyholder would be forfeited by the insurance company
  • Any sub-limits or co-payments applicable under the health insurance policy would continue to apply
  • The new guideline would apply only to indemnity oriented health insurance plans which cover the actual cost of hospitalisation
  • Health insurance companies would have to settle or reject their claims within 30 days of receiving all claim-related documents. If there is any delay in claim settlement, the insurance company would be liable to pay interest on such delay. The interest payable would be calculated @ bank rate + 2%.
  • Even in the case of portability, the moratorium period would be applicable on the ported policies from the date the policy was first bought. For instance, if you buy a policy on 1st June 2020, the moratorium period would end on 1st June 2028 irrespective of the number of times you port the policy to another insurance company.

Impact of the guidelines

IRDAI has issued these guidelines to simplify the claim process of health insurance plans and to protect policyholders from the fear of claim rejections in their existing health insurance plans. With these guidelines, the claim related terms and conditions of health insurance policies would be simplified for the common man and you can expect quick and easy settlement of your health insurance claims.

So, in a nutshell, this move by the insurance regulator would ease your claim settlement process. You would not have to lose your sleep on health insurance claims once eight years have passed. Your claims would be settled easily and quickly.

The IRDAI is the insurance regulator which makes necessary changes and regulations in the interest of policyholders. This guideline is also aimed in the best interest of policyholders and would definitely give you an advantage in your health insurance claims.

Top 7 things to know about COVID Health Insurance

The recent Coronavirus pandemic has gripped the world in its clutches and there seems to be no relief in sight. The infection is spreading across the world and more and more people are getting infected and being hospitalised for treatment. In case of hospitalisation, considerable costs are incurred and many of you might find such costs unaffordable. This is where you seek out a health insurance policy to cover the hospitalisation costs incurred on COVID. But do you know whether the health insurance policy would cover the relevant expenses incurred on COVID?

Insurance is a technical concept and you need to know the terms and conditions of your policy to know the coverage that you can expect from your policy. In recent times, given the spread of COVID, health insurance companies have launched COVID insurance plans. These plans are disease specific policies which help in covering the medical costs and other financial obligations suffered due to Coronavirus. Moreover, the Insurance Regulatory and Development Authority of India (IRDAI) has ensured that your regular health insurance policies would also cover the medical costs of the COVID pandemic. So, COVID insurance has become a reality but there are various questions attached with it. Existing policyholders as well as individuals considering investing in a COVID insurance policy have some queries with regards to the Coronavirus insurance coverage that they can expect. So, let’s answer some common questions about COVID health insurance and simplify the coverage for you –

Commonly asked questions about COVID insurance in India

    1. Is COVID-19 claim payable under my health insurance policy?Thanks to the guidelines issued by the IRDAI, all health insurance policies cover hospitalisation costs incurred due to Coronavirus. So, if you have an existing health insurance plan and unfortunately you are hospitalised after being tested positive for the virus, the associated costs of such hospitalisation would be covered under your health insurance policy, provided the pandemic is not considered as an exclusion. Moreover, if you are under quarantine and you undergo medical treatments, the costs of such treatments would also be covered under the plan.
    2. What is the waiting period for COVID-19 insurance claims?If you have an existing health insurance policy, there would be no waiting period for COVID-19 claims. However, if you buy a new indemnity health insurance plan or a new COVID insurance policy, there might be an initial waiting period of 30 days to 90 days, depending on the policy’s terms and conditions, during which COVID-19 claims would not be admissible. If you are tested positive for the virus and are hospitalised during this initial waiting period, the claim would not be paid.
    3. Can hospital quarantine expenses due to COVID-19 be claimed?The guideline for coverage of quarantine expenses was also issued by the IRDAI. According to such guidelines, if you are quarantined for COVID and you undergo medical expenses at a registered medical facility such expenses would be reimbursed by the health insurance policy. The point to note here is that the expenses which would be covered should be medical in nature and should relate to the treatments taken during such quarantine. Any other ancillary expenses which are not related to medical treatments would not be covered.
    4. Can expenses due to quarantine because of COVID – 19 at home be claimed?If you are quarantined at your own home for COVID-19, expenses incurred on medical assistance would not be admissible in a normal indemnity oriented health insurance plan. The health insurance plan covers hospitalisation related expenses and since home quarantine does not involve hospitalisation, no coverage is allowed under the policy. However, if you buy a COVID insurance scheme which specifically covers Coronavirus, you get a lump sum benefit if you are tested positive for the virus. This lump sum benefit is payable whether you are hospitalised or you are quarantined at home.
    5. Is the cashless treatment possible for COVID-19 in government hospitals?Cashless treatments under health insurance plans are allowed if you get treated in a hospital which is tied-up with the insurance company. So, if the Government hospital is a networked hospital, you can avail cashless treatments for COVID-19. However, if the hospital is not tied-up with your insurance provider, claims would be settled on a reimbursement basis. You would have to bear your medical costs initially and after discharge from the hospital, the medical bills should be submitted to the health insurance company for reimbursement of the costs incurred.
    6. What is the approximate cost of treatment of COVID-19 infection?The cost of treating COVID-19 is not standardized. It depends on the hospital’s pricing policies, age of the patient, comorbidities, severity of the infection, etc. In initial stages, if you can get treated in the general ward, the expenses are lower. However, for severe complications, an ICU and a ventilator are a must which add to the cost. Basically, considering the doctor’s fee, consumables, room rent, cost of medical tests and treatment costs, the average daily cost of hospitalisation in a private hospital can range between INR 20,000 to INR 25,000. If ICU and ventilator are added to this equation, the cost shoots up to INR 50,000 to even a lakh. So, a 10-day stay in the hospital easily amounts to lakhs and you need sufficient health insurance coverage at your disposal to meet such considerable costs.
    7. Are specialized COVID insurance plans and normal health plans different from one another?Given the rising threat of the Coronavirus pandemic, many health insurance companies have launched COVID specific health insurance policies to cover the disease. These health insurance plans are different from the normal health insurance plans which are available in the market. Discussed below are the differences between the two –
COVID insurance policy Normal health insurance policy
This is a fixed benefit health insurance plan which pays a lump sum benefit if you test positive for Coronavirus This is an indemnity oriented health insurance plan which covers the cost of hospitalisation and medical treatments only when you are hospitalised for Coronavirus infection
The total sum insured is paid in lump sum as claim The claim amount depends on the actual medical costs incurred on COVID treatment
Any financial liability can be met with the benefit received from the COVID insurance scheme The claim payable under the policy is only for the medical costs incurred on COVID treatment
The policy does not cover any other medical contingency which you might suffer A normal health insurance policy offers a wide scope of coverage and covers other illnesses and injuries besides COVID which requires hospitalisation

Thus, both COVID insurance plans and normal health insurance plans are different from one another and should not be considered the same.

Here is a quick synopsis of facts about COVID coverage –

health insurance

Best health insurance plans for COVID

Given the requirement of insurance coverage for meeting the costs of COVID treatments, health insurance plans with COVID coverage have become essential. Here are some of the best plans which provide Coronavirus insurance coverage under their scope of coverage –

    • COVID specific health plansThese plans are especially designed to cover Coronavirus and pay a claim if you test positive for the virus and undergo treatments. These plans are fixed benefit plans which pay the sum insured in lump sum on diagnosis of COVID. Some of the best COVID insurance plans are as follows –
      1. GoDigit Health Care Plus PolicyThis plan is a fixed benefit COVID-specific health plan which pays a lump sum benefit if you are diagnosed with Coronavirus. The sum insured ranges from INR 25,000 to INR 2 lakhs and is paid in lump sum if you are tested positive for the virus. In case of quarantine in a Government facility, 50% of the sum insured is paid in lump sum for meeting your financial needs. There is a small waiting period of 15 days after which coverage is allowed. Premium for the policy is quite low and starts at INR 299 only.
      2. Star Novel Coronavirus Insurance Policy Another fixed benefit plan offered by Star Health, the policy has a waiting period of 16 days. No pre-entrance health check-ups are needed to buy the plan and two coverage levels are allowed – INR 21,000 and INR 42,000. You can add family members to the coverage but the sum insured would be allowed on an individual basis only. The lump sum benefit is paid if you test positive for COVID and are hospitalised for treatments.

        Here’s a comparative analysis of these plans –

        Name of the plan Sum insured Premium rate Waiting period Benefit paid
        GoDigit Health Care Plus Policy INR 25,000 – INR 2 lakhs INR 299 onwards 15 days 100% in case of testing positive and 50% in case of quarantine at a Government facility
        Star Novel Coronavirus Insurance Policy INR 21,000 and INR 42,000 INR 299 and INR 598 respectively for the sum insured levels 16 days 100% of sum insured in case of testing positive
    • Normal health insurance plansWhile the above-mentioned plans cover only COVID, normal health insurance plans are those which cover other medical contingencies too and have a wider scope of coverage. Some of the leading health insurance plans which cover the hospitalisation and treatment costs of Coronavirus are as follows –
      1. HDFC ERGO Health Optima RestoreA comprehensive health insurance policy, Optima Restore allows coverage up to INR 50 lakhs. The policy has a restore benefit which restores the full sum insured during the policy year after a claim has been made. This allows you to avail double coverage under the plan. Moreover, the multiplier benefit increases the coverage by 50% after each claim-free year without any additional premium. You can also get premium discounts if you take a specified number of steps within a policy year and stay healthy.
      2. Religare CareA comprehensive health insurance policy offered by Religare, Care allows coverage up to INR 6 crores. The plan has a range of inbuilt coverage benefits and also allows a variety of optional add-ons which can be chosen to enhance your coverage. Free health check-ups are allowed every year and you can also enjoy international coverage under the Care Anywhere benefit available with the plan.
      3. Star Comprehensive Insurance Policy A popular family floater plan, the policy has no limit on the room rent in case of inpatient hospitalisation. You can get coverage for air ambulance, domiciliary treatments and second medical opinion through the policy. Maternity expenses are also covered and you also get coverage for bariatric surgery which is a unique coverage feature of the plan. The policy has a wellness program too which motivates healthy living and allows premium discounts on maintaining a healthy lifestyle.
      4. Manipal Cigna ProHealth Insurance The ProHealth range of insurance plans offered by Manipal Cigna comes in different variants with staggering sum insured levels. You can, therefore, choose a variant as per your coverage requirement. The policy has the benefits of sum insured restoration, international coverage, maternity coverage and annual health check-ups. You can opt for high sum insured levels too as the plan allows coverage up to INR 1 crore.
      5. Max Bupa Health PremiaHealth Premia is a newly launched health insurance plan offered by Max Bupa which boasts of some of the best coverage benefits. You can get coverage up to INR 3 crores under the policy and there are three variants of Silver, Gold and Platinum. Sum insured restoration, international coverage, travel insurance coverage, health check-ups, etc. are some of the notable coverage benefits of the plan.

        Here’s a quick look at these plans –

        Name of the plan Sum insured Pre-existing waiting period Salient features
        HDFC ERGO Health Optima Restore INR 3 lakhs – INR 50 lakhs 36 months · Free e-opinion for critical illness

        · 100% restoration of sum insured

        · Multiplier benefit doubles the sum insured within two claim-free years

        Religare Care INR 4 lakhs – INR 6 crores 48 months · Range of add-ons to customize the plan

        · Free annual health check-ups

        · 100% sum insured restoration

        Star Comprehensive Insurance Policy INR 5 lakhs – INR 25 lakhs 48 months · Air ambulance cover

        · OPD cover for medical consultations

        · Bariatric surgery is covered

        · Automatic restoration of sum insured

        Manipal Cigna ProHealth Insurance INR 2.5 lakhs – INR 1 crore 24-48 months depending on the plan variant selected · Worldwide coverage in case of an emergency

        · OPD coverage through health maintenance benefit

        · Expert opinion in a critical illness

        Max Bupa Health Premia INR 5 lakhs to INR 3 crores 24 months · Coverage for advanced new age treatments

        · International coverage available

        · Inbuilt coverage for travel insurance

So, take your pick from the above-mentioned health insurance plans to protect yourself from the financial implication of Coronavirus infection. If you have an existing health insurance policy, your policy would cover your hospitalisation and treatment expenses which incur due to Coronavirus. However, you should ensure that the coverage level of your plan is sufficient. COVID related hospitalisation can amount to lakhs and a sufficient sum insured is needed to meet the medical costs sufficiently. If your coverage is low, enhance your coverage through another health plan or through a top-up plan. You can also buy a specific COVID insurance scheme to get a lump sum benefit in case of COVID infection.

Assess your needs and then make an informed choice. Also know the coverage benefits of your health insurance policy so that you have clarity about raising a claim for Coronavirus.

Information on Aarogya Setu App and how does it work

The Coronavirus pandemic has become a global threat and it is claiming an increasing number of lives world over. Even in India, the number of infected individuals has crossed the 2.5 lakh mark (as on 8th June 2020) and the numbers are expected to increase in future. To curb the spread of the disease, the Indian Government took some bold measures like initiating a nationwide lockdown. Moreover, to prevent community spread and to educate individuals about the safety protocols for battling the pandemic, the Government also introduced the Aarogya Setu mobile application. Let’s understand what this application is all about –

What is the Aarogya Setu app?

Aarogya Setu is a mobile application developed by the Indian Government. The application can be downloaded on any Smartphone and can be used to track the spread of Coronavirus, learn about prevention measures, assess the health risk of an individual and to find hotspots near one’s location. Thus, this is a multifaceted app which helps individuals keep themselves safe from Coronavirus infection.

Features of the Aarogya Setu application

The Aarogya Setu mobile application is a digital initiative by the Government to connect with the population and educate them about the possible spread of infection. The salient features of the app are as follows –

  • The application works on the principle of contact tracing to find out the number of people you have come in contact with and if anyone among them presents a risk of infection
  • There is a self-assessment test on the application which is based on the guidelines issued by ICMR (Indian Council of Medical Research)
  • All latest COVID updates can be found on the application
  • If you have applied for an e-pass and you have received it, the information would be available on the application. You can, therefore, use the application to keep the pass at your fingertips

Aarogya Setu application

How does the Aarogya Setu application work?

The Aarogya Setu application uses your phone’s Bluetooth and Location services to work. When you come in contact with an individual who also has the application installed on his/her phone, the application detects the digital signature of the individual’s application and there is an exchange of information of this contact. The information includes the time, date and location of the contact. Thereafter, if any of you test positive for COVID, the application would calculate the risk of infection of the other person. This calculation is done considering how recent was the contact and how proximate you were on such contact. If there is a threat of infection, the application updates you about the same through a notification. The Government is also informed allowing it to take measures to contain the spread of infection by providing the necessary medical care.

How to download Aarogya Setu app?

It is quite simple to download and use the Aarogya Setu app. The relevant steps are listed below –

  • If you have an Android phone, visit the Play Store and search for the Aarogya Setu app. For iPhone users, the app would be available for download in the Apple Store.
  • Install the application on your Smartphone
  • Once the application opens, you would be asked to choose your preferred language. There are 12 language options including English, Hindi and other regional languages
  • The app helps in tracking your proximity to a COVID positive individual in your area. You, therefore, have to switch on the ‘Location’ service (GPS) and Bluetooth on your Smartphone.

How to use Aarogya Setu app?

Once you have downloaded the application, using it is quite easy. You would, first, have to register yourself before you start using the Aarogya Setu app. The process of registration and ways to use the app are as follows –

  • After you have selected the preferred language and read through the app’s features, you would have to choose ‘Register Now’
  • The permission for turning on your Bluetooth would be asked which you should agree to
  • The terms of service of the application would be shown and you should click on ‘I Agree’
  • Enter in your mobile number and an OTP would be sent to your number
  • The OTP would be auto-filled and you would have to provide your personal details. These details would include your gender, full name, age, profession, your travel history and whether you would volunteer in an emergency
  • Once the details are provided, click on ‘Submit’
  • Then you would be asked of your recent health status. There would be a 20-second self-assessment test which you can take immediately or at a later time
  • You can, then, view the home page of the application wherein you would get updates about the number of users in your area and possible hotspots. You can also check your risk of infection and read up on measures to prevent yourself from infection.

Self-assessment health check-up on the app

One of the best features of the Aarogya Setu mobile application is the self-assessment health check-up which allows you to assess your current health condition and find out whether you face a risk of COVID infection or not. This assessment has been designed on the guidelines of the ICMR. The test asks you several questions to determine whether you face any danger of infection or not. The questions include the following –

  • Whether you are suffering from specific symptoms like cough, fever and difficulty in breathing or nothing
  • Whether you have had any pre-existing illness like diabetes, hypertension, lung disease or heart disease
  • Your international travel history within the last 28-45 days
  • Whether you have interacted with a COVID positive individual or not or whether you are a healthcare worker or not

When you answer the questions successfully, your infection risk would be calculated and shown. You would also be advised on the course of action that you should take based on your infection risk.

Benefits of the Aarogya Setu application

The Government of India took a very good step in launching the Aarogya Setu application and promoting its use. The application is quite beneficial in the following respects –

  • The self-assessment test lays your infection worries to rest by showing you your infection risk. Even if you are in a hotspot, you can take the assessment test and check whether you are exposed to the risk of infection or not.
  • Since the application tracks individuals near you who can be infected, it informs you of positive cases so that you can eliminate contact with the infected person in your area. Moreover, if you have come in contact with an infected individual, the application advises you on self-quarantine to prevent the spread of the virus.
  • You can check the list of laboratories near you for COVID testing through the app
  • The application is integrated with e-pass if you have availed the same to travel during the lockdown. The e-pass details can, thus, be stored on your mobile and can be accessed anytime that you need
  • The application sends you regular notifications about Coronavirus spread near you. This helps you remain updated about the disease so that you can prevent a possible infection
  • If you are COVID positive and you need help, you can contact the COVID helpline number directly from the application and get medical help without having to step out from your house

The Aarogya Setu app is a good initiative by the Indian Government which is aimed to track and break the chain of the spread of the virus. You can use the application to track the number of cases in your proximity so that you can take the necessary steps to avoid contracting the virus.

Frequently Asked Questions

  1. Is the result of the self-assessment test shared with the Government?The self-assessment test assesses the risk of infection that you face. If you face a moderate or high risk of infection, the application would ask for your consent to share the results with the Health Ministry. Only if you allow would your result be shared with the Government. It is recommended that in high-risk cases, the results should be shared with the Government so that necessary medical assistance can be arranged.
  2. How does the application notify about a COVID positive individual?If an individual has taken a COVID test and the result is positive, the information is shared with ICMR. ICMR, then, shares the list of positive patients with the Aarogya Setu application server. If the patient has the Aarogya Setu application installed on his/her mobile phone, it is updated on the application and the patient’s contact tracing is done to find out about individuals who might have come in contact with him/her.
  3. Is my personal information shared on the application safe?Yes, your personal information is always kept safe and the application does not share it with any third party.

Information on Arogya Sanjeevani Health Insurance

A health insurance policy has become a necessary requirement in today’s times when medical costs have become too expensive to afford. The middle-class man finds himself in a financial crisis if a medical emergency strikes himself or his family members. Meeting the expensive medical costs puts a dent in his finances and a health insurance policy is needed to avoid this dent. 

Given the need for health insurance, people are increasingly becoming aware of the importance of having health insurance coverage and are investing in a comprehensive policy to cover their medical emergencies. However, insurance is a technical concept and each health insurance company promises to offer something better in its health insurance plan compared to its competitors. This confuses a layman in choosing a comprehensive yet affordable health insurance plan for himself and his family. Keeping this dilemma in view, the Insurance Regulatory and Development Authority of India (IRDAI) proposed a standard health insurance plan to be offered by all insurance companies. Therefore, in accordance with IRDAI’s proposal, the Arogya Sanjeevani health insurance policy was launched and currently, almost all insurance companies are offering the policy to individuals. Let’s understand what this policy is all about and its features –

What is the Arogya Sanjeevani policy?

The Arogya Sanjeevani health insurance plan is a standardized health insurance plan which offers uniform coverage benefits and has the same features across all insurance companies. The policy is an indemnity oriented health insurance plan which covers the medical costs incurred when you are hospitalised. Though all insurance companies offer the same uniform features and coverage benefits under the Arogya Sanjeevani policy, the premium of the policy is not the same across insurers. The premium is determined by the insurance company according to its pricing policies.

Salient features of Arogya Sanjeevani

The Arogya Sanjeevani plan is the first-ever standardized health insurance plan which is being offered in the Indian health insurance market. Here are some of the salient features of the policy which you should know about –

  • The Arogya Sanjivani policy is issued for a tenure of one year after which you can renew it for continued coverage 
  • The policy is offered both as an individual plan and a family floater plan
  • There is a no claim bonus offered by the policy if you don’t make a claim in a policy year. The bonus is a 5% increase in the sum insured without any additional premium. This bonus is cumulative in nature and it continues increasing the sum insured for each subsequent claim-free year up to a maximum of 50% of the original sum insured.
  • There is a waiting period of 4 years for pre-existing illnesses, joint replacement surgeries and age-related osteoporosis and osteoarthritis. For other specified illnesses, the waiting period is 2 years.
  • The premium of the policy varies across insurers. It depends on your age, medical history, number of members covered and the sum insured chosen 
  • No pre-entrance health check-ups are needed until 45 years of age
  • Eligibility criteria for Arogya Sanjivani

    To be able to buy an Arogya Sanjeevani policy, the following eligibility criteria should be fulfilled –

    Age criteria 

    Adults aged between 18 and 65 years can buy the plan

    Dependent children aged between 3 months and 25 years can be covered under the family floater variant

    Independent children aged 18 years and above cannot be covered under the family floater plan

    Members covered

    Individual plan – self 

    Family floater plan – self, spouse, dependent children, dependent parents, dependent parents-in-law

    Sum insured 

    INR 1 lakh to INR 5 lakhs

    Renewability 

    Lifelong renewability is allowed 

    Co-payment 

    5% of each and every claim amount

Coverage benefits of Arogya Sanjeevani plan

The Arogya Sanjeevani policy covers basic medical costs and also the costs incurred on new-age treatments in keeping with the development in medical science. The coverage benefits of the policy are as follows –

  1. Pre and post hospitalisation expenses

    Expenses incurred before being hospitalised are called pre-hospitalisation expenses. Such expenses are covered for 30 days before hospitalisation. Similarly, post hospitalisation expenses are those which are incurred on recovery after you are discharged from the hospital. Such expenses are covered for up to 60 days after discharge. 

  2. Inpatient hospitalisation 

    Inpatient hospitalisation expenses are those expenses which are incurred when you are hospitalised for 24 hours or more. These expenses include room rent, nurse’s fee, doctor’s fee, surgeon’s fee, blood, medicine, oxygen, etc. Such expenses are covered up to the sum insured. However, there is a sub-limit on room rent and ICU room rent. The limit on room rent is 2% of the sum insured subject to a maximum of INR 5,000 per day and for ICU room rent it is 5% of the sum insured subject to a maximum of INR 10,000 per day.

  3. Ambulance expenses 

    The charges incurred in hiring an ambulance to take you to the hospital are covered under the policy. The maximum coverage limit is INR 2,000 per instance of hospitalisation.

  4. Daycare treatments

    Treatments which do not require 24-hour hospitalisation due to advanced medical techniques are called daycare treatments. Such treatments are covered under the Arogya Sanjeevani plan for up to 50% of the sum insured.

  5. AYUSH treatments

    Non-allopathic treatments like Ayurveda, Unani, Homeopathy and Siddha are covered under the policy for up to a specified limit of the sum insured.

  6. Dental treatments and plastic surgery

    If due to an illness or injury, you are required to undergo dental treatments or plastic surgery, the cost of such treatments would be covered by the policy. Coverage would be allowed up to the sum insured of the plan.

  7. Cataract treatment

    Treatment for cataract would be covered for up to 25% of the sum insured subject to a maximum of INR 40,000 per eye.

  8. New age treatments

    To make the Arogya Sanjeevani policy suitable for the modern times, coverage for new-age treatments is extended under the scope of the plan. The coverage for such treatments is restricted to 50% of the sum insured. The treatments which fall under the category of new-age treatments and are covered by the plan include the following –

    • Uterine Artery Embolization and High intensity focused ultrasound (HIFU)
    • Balloon Sinuplasty 
    • Deep Brain Stimulation
    • Immunotherapy
    • Oral Chemotherapy
    • Vaporization of The Prostate
    • Intra Operative Neuro Monitoring (IONM)
    • Intravitreal Injections
    • Stem cell therapy 
    • Robotic surgeries
    • Stereotactic Radio Surgeries
    • Bronchial Thermoplasty

Exclusions under Arogya Sanjeevani

Although the scope of coverage of the Arogya Sanjeevani plan is quite extensive, the policy does have exclusions in which case claims are not paid. Common exclusions under the plan are as follows –

  1. Diagnostic costs
  2. Medical costs incurred due to activities which breached common law, participation in hazardous activities and due to substance abuse
  3. Any type of cosmetic surgery or gender change treatments
  4. Weight control treatments
  5. Treatments for vision correction
  6. Infertility treatments
  7. Medical emergencies suffered due to war
  8. Rehabilitation expenses
  9. Maternity expenses
  10. Expenses incurred on dietary supplements
  11. Medical treatments taken outside India and the associated medical expenses

Sample premium rates of Arogya Sanjeevani

Though the premium rates of the Arogya Sanjeevani policy vary across insurers, the rates can be compared. Here are the sample rates of leading insurance companies for individual health insurance coverage taken by a 35-year-old man for a sum insured of INR 5 lakhs.

Arogya Sanjeevani

Name of the company 

Name of the company 

Premium rate 

Star Health Insurance 

INR 4921

Manipal Cigna

INR 7432

SBI General Insurance

INR 4044

New India Assurance

INR 5999

Benefits of Arogya Sanjeevani

Arogya Sanjeevani health insurance policy offers the following benefits to policyholders and is therefore recommended –

  • If you are looking for an affordable yet comprehensive health insurance plan, you can opt for Arogya Sanjeevani and get yourself and your family members covered
  • The plan also covers new age modern treatments which might usually not be covered under other basic health insurance plans
  • Since the coverage features are standard, you can buy the policy online through any insurance company after comparing the premium rates charged
  • The premium paid for the Arogya Sanjeevani policy is eligible for deduction under Section 80D. The maximum deduction which you can claim is INR 25,000 which increases to INR 50,000 if you are a senior citizen.

The Arogya Sanjeevani health insurance plan is a basic and comprehensive health insurance policy which allows you coverage against medical expenses. If you are looking for affordable health insurance coverage which does not compromise on the coverage features, you can choose the policy and get yourself and your family members covered under the plan.