Covid-19 insurance to cover PPE cost: Insurance regulatory body

POLICY WILL COVER THE COSTS OF TREATMENT AND DIAGNOSTIC TESTS CONDUCTED AT HOME

MUMBAI: The Insurance Regulatory and Development Authority of India (Irdai) has revised the proposed standard norms for standard Covid-19 health insurance policies, saying all general and health insurers will have to offer two products: an indemnity and a benefit-based health product for Covid-19 from 15 July.

Irdai had earlier withdrawn the indemnity policy proposed in the first week of June and had recommended a benefit-based cover.

The new draft guidelines, reviewed by Mint, proposes to cover the costs of PPE kits and have no sub-limits on room rent.

It has set the minimum entry age for both policies at 18 years and the maximum at 65. In the indemnity policy, dependent children, aged three months to 25 years, will be covered. The tenure could be three months, six months, or a year.

The revised indemnity policy will have a minimum sum insured of ₹50,000, and goes up to ₹5 lakh in multiples of ₹50,000.

The policy will pay for hospitalisation expenses, room, boarding and nursing expenses, as well fees for surgeons, anaesthetists, consultants, and specialists, including consultation through telemedicine. Other costs such as oxygen support, operation theatre charges, surgical appliances, medicines, PPE kits, and gloves will be admissible if hospitalized for a minimum of 24 hours.

It will also cover intensive care unit and intensive cardiac care unit expenses. Unlike the earlier draft, the revised policy does not have any sub-limits on room rent.

The policy will also cover the costs of treatment at home, provided a medical practitioner advises home treatment and there is a continuous active line of treatment which requires monitoring of health status by a medical practitioner. Diagnostic tests conducted at home or at diagnostic centres, medicines, consultation and nursing charges, and cost of the oximeter, oxygen cylinder and nebulizer will be covered under the home care benefit. Ayush treatment, pre-hospitalisation expenses 15 days prior to the date of hospitalisation and expenses incurred 30 days after hospitalization shall be covered.

Irdai has left it to the insurance company’s discretion to decide the premiums, and the policy will be made available on a family floater basis as well. Benefit-based policies will pay a lump sum benefit equal to 100% of the sum insured if the policyholder tests positive for Covid-19 and requires hospitalisation for a minimum of 72 hours. The product will cover an individual only.

The earlier proposed add-on for a quarantine cover has now been removed. The minimum sum insured shall be ₹50,000 and the maximum limit is up to ₹3 lakh. An individual will be allowed to purchase only one such policy.