Your Questions Answered on Insurance Claims amid Coronavirus

2020-08-14

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With the Corona Virus outbreak tormenting the world, millions of people have died in every corner of the earth. The global economy is in peril, and hospitals are struggling for beds and other equipment. Many have lost their jobs, and daily life has come to a standstill.

In this scenario of panic, every individual wants to be safe and healthy. They are concerned about issues like whether they are eligible for insurance pay-outs when they contract and get impacted by COVID. They wish to know if life insurance like term insurance plans and health insurance will be covered for Covid-19 infection or death. Most insurance companies have been flooded with enquiries with anxious customers wishing to know the extent of coverage offered by the insurers and impact of the pandemic on their existing policies.

The following are the major questions posed by customers and the answers related to them:

Is Death Due to Corona Covered Under Term Life Insurance Plans?

Many holders of term policy have been badgering their insurers about whether they are eligible for death claims caused by the pandemic. In turn, life insurers have clarified that death claimed due to Covid-19 infection will be treated on equal terms just like any general death and the claim will be admissible if the infection was diagnosed for the policyholder, after issuance of policy and finishing of waiting period (1 year). No special conditions and terms are applicable for death due to Covid-19, and this will be treated as any other case of death. In fact, the life insurance industry has taken up some active steps since the outbreak of the virus, one of them being cover for death due to Covid-19 as part of the life insurance policy. This is to calm down frantic persons regarding the pandemic.

Will Nominees of Existing Policies Get Death Benefits?

In case an individual passed away due to the viral infection and had an existing life insurance policy, the nominee will gain the sum assured as a death benefit. This implies that when an insured person dies, the death benefit will be paid to the nominee after filing of a valid claim for life insurance.

The death benefit is the agreed sum of money (sum assured) payable by the insurer on the death of the policyholder to his nominee or beneficiary. When one buys a policy, one will declare some person/persons as nominees. Nominees can ascertain the sum assured in the policy document.

The good news for the public is that coronavirus infection will be covered if you have an existing life insurance policy. In the rare event of your death from the pandemic illness, your nominee will gain the death benefit.

Is There Cover of Covid-19 Infection in Regular Health Insurance Policy?

According to guidelines issued by the IRDAI (Insurance Regulatory and Development Authority of India), all the claims related to Covid-19 treatment (including quarantine period) will be eligible to gain coverage under a standard health plan. It will be there to help the insured with the normal cover on hospitalization for all viral infections, including Corona. All the features you enjoy under your chosen health insurance plan will also apply to Covid-19 treatment. But to avail treatment through your medical insurance, you must be hospitalized at least for 24 hours. In the event of hospitalization, all your expenses will be covered for treatment of disease, including pre and post hospitalization expenses.

If I buy an insurance policy now, will it cover covid-19?

In case you are planning to buy a life insurance policy at this point of time, know that insurers will determine the premiums based on your medical history and current state of health. Therefore, it is reasonable to conclude that a global crisis like the pandemic would have some impact on your policy acceptance and premiums, especially if your policy is in the application stage. Your insurer may hold or reject the policy if you have already contracted the infection. Hence, all policyholders should dissect all the exclusions of their life insurance policy to know what would not be covered.

How to Buy Policies under Lockdown?

The good news is that one can easily purchase life and health insurance policies through an online web-aggregator or the website of the insurer. But for both term and health insurance, one must undergo a medical check-up.

With the whole country under lockdown, insurers have simplified their underwriting process by offering insurance (life and term) to customers through telemedicine (distance mode for underwriting), instead of conducting physical medical tests at medical centres.

For encouraging social distancing, insurers have partnered with major online aggregators to provide policies to potential customers through telemedical consultation. As per the latter, while buying a term or health insurance, the customer will have to submit some information on their health condition to an appointed doctor, by phone. One can purchase a health insurance plan up to 2 crores sum insured and a term plan with 1 crore sum assured, by using the telemedicine facility.

Canara HSBC is an insurance company which has, in addition to setting up special claims help desk to expedite the claim settlement process, have designed customized online insurance plans for all persons impacted by the pandemic. They are accepting claim intimations via e-mail. Since the crisis has disrupted the postal and courier services, they are sending all communications via e-mail and SMS.

What If Life Insurers Consider Covid-19 As Critical Illness?

Usually, life insurance policies do not deny payments of benefits for deaths caused by any illness. But one must consider conditions set by life insurance policy add-ons, whose benefits will be paid out only if such conditions are adhered to. For example, in the case of life insurance policies with critical illness benefits, claims may not be entertained when the policyholder does not comply with medical advice.

What Is the Cost of Treatment of Covid?

The cost of COVID treatment in private hospital rooms amounts to Rs. 2 lakhs in tier 3 cities, Rs. 3 lakhs in Tier 2 cities and Rs. 5 lakhs in Tier 1 cities. Cost in super-speciality hospitals could cost Rs. 7 lakhs in tier 2 cities and Rs. 8 lakhs in metros.

These are all some important doubts clarified about insurance coverage during the times of the Corona Virus pandemic.

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