Authored by Amit Chhabra
COVID-19 positive cases in India have surged past the 12 lakh figure, however, in the last few months, less than 50,000 people have so far utilized their health insurance policy for the treatment of the novel coronavirus.
According to numbers collated by insurance companies, approximately only 50,000 claims have come to insurers for a settlement involving a cumulative amount of Rs 625 crore — this works out to an incurred expenditure of Rs 1.25 lakh, on an average, per policyholder.
The 50,000 claims, when viewed against the over 12 lakh COVID-19 cases, translates to just 4.1 percent of the individuals who tested positive and had some kind of health insurance coverage. It is believed that most individuals having health insurance are most likely to be covered under a state health insurance scheme such as Ayushman Bharat, employer-provided health insurance, or some private insurance company.
Claims Filed from the Different Indian States
As per the data provided by health insurance companies, the highest number of health claims are being filed in Maharashtra as the state claims about 60 percent of the total claims filed. It is followed by Delhi with 15 percent and 10.4 percent of claims have been made in Tamil Nadu.
The total claims that have been filed in West Bengal are 5.4 percent while those filed in Gujarat stand at 3.4 percent. The remaining 5.8 percent of the claims have been filed in other Indian states.
Cost of Treatment of COVID-19
On average, the total cost of treatment of the novel coronavirus claim without ventilators or other life-saving equipment is between Rs 10,000 and 15,000 daily that makes for Rs 1.5 – 2 Lakh for a period of 14-days in urban areas and Rs 75,000 – 1 Lakh in semi-urban or rural areas.
However, where ever the condition of the patient is serious or where co-morbidities are involved and the patient needs to be admitted to the intensive care unit (ICU), the claims are in the range of Rs 6 - 8 Lakh if the patient is aged between 30 – 45 and the amount goes up to Rs. 12 Lakh if the patient is above the age of 50. Usually, patients are discharged once three to five consecutive tests turn negative. In some cases, tests may go up to eight to ten to get a definite result.
Time to Prioritise Health Insurance
While it is important to follow all government advised measures to protect yourself physically from getting infected with coronavirus infection, it is also very important to stay financially protected against the epidemic. The only and most convenient way to stay financially protected against the treatment of the infection is by buying an adequate health insurance policy.
Unlike all other medical expenses for hospitalization, if one gets hospitalized for treating coronavirus infection, the health insurance plan will come in rescue to safeguard medical expenses. Buying a health insurance plan not just for yourself but for your entire family is important to make sure your hospital admission and treatment expenses are covered seamlessly.
Your health insurance policy will cover you for testing and the cost of treatment for the novel coronavirus. On the directions of the Insurance Regulatory and Development Authority of India (IRDAI), all the general and specialized health insurers have been advised to process all claims related to COVID-19 within 2 hours of the claim request.
Moreover, while most insurers were not covering consumables like PPE kits under the health insurance due to the which the hospital bills of the COVID-19 positive cases were going up, the regulator has now requested the insurance companies to cover the same under health insurance claims. Thankfully, on request of IRDAI most prominent insurers like Religare, Max Bupa, HDFC Ergo, Aditya Birla Capital and Star Health have now started covering the cost of PPE kits and other consumables under regular health insurance plans.
Choose a Plan as Per Your Pocket
In order to avail adequate coverage against COVID-19 and all other ailments, it is best advised to buy a comprehensive health insurance policy with the maximum sum insured. A regular health insurance policy with Rs. 10 Lakh sum insured for 32-year-old individual costs anywhere between Rs. 7,000 – 9,000 annually.
However, if you feel you cannot afford to pay the entire amount as a lump sum, you may choose to pay the premium in monthly or quarterly payments as per your own convenience. Moreover, considering the financial stress due to job losses, sales dip and pay cuts that most salaried professionals and businessmen are facing all across the nation due to the corona crises, on the direction of the IRDAI, insurers have come up with standard COVID-19 specific plans that provide adequate coverage against the novel coronavirus.These are short-term plans available for a period of 3.5 months, 6.5 months and 9.5 months with a sum insured ranging from Rs. 50,000 to Rs. 5,00,000.
The plans have been named Corona Kavach - indemnity based health plan and Corona Rakshak - fixed benefit health insurance policy.
These Individual COVID specific Standard Health Policies will address the basic health insurance needs of insuring public for COVID-19 with common policy wordings across the industry. Customers can either buy these policies through the insurer’s websites, online web aggregators, or directly approach the branch offices or agents of the insurance companies.
The Corona Kavach is available for as low as Rs. 208 for a policy tenure of 3.5 months with Rs. 50,000 sum insured. In the case of Bajaj Allianz, the lowest premium is Rs 447 for a Rs 50,000 sum insured for a customer up to the age of 35 years for 3.5 months.
The premium rises with age and period. The same customer will have to pay Rs 745 for a 9.5-month policy which is the maximum period. For the maximum sum insured of Rs 5 lakh, the individual will pay Rs 1,320 with the premium rising to Rs 5,630 for those over 60.
Amit Chhabra is Head-Health Insurance, Policybazaar.com