Taking COVID 19 treatment at home? How to claim reimbursement under Corona Kavach and Corona Rakshak
The Insurance Regulatory and Development Authority of India came up with two policies last year; Corona Kavach Policy and Corona Rakshak Policy. The Corona Kavach is a floater policy that covers the entire family, and the Corona Rakshak as the name suggests is an individual policy that only covers the individual holder.
Amid the throes of the second wave of the Covid-19 outbreak, with the shortage of hospital beds and oxygen cylinders, many people are forced to stay at home and treat themselves indoors. There is a Catch-22 situation for many! As most of them are wondering if a patient has a health insurance policy, then how can it claim for reimbursement without admitting to the hospital. Well of course you can! The patient can claim the cost of treatment without getting admitted to the hospital.
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Considering the same, the Insurance Regulatory and Development Authority of India (IRDAI) came up with two policies last year; Corona Kavach Policy and Corona Rakshak Policy. The Corona Kavach is a floater policy that covers the entire family, and the Corona Rakshak as the name suggests is an individual policy that only covers the individual holder.
IRDAI has advised all the general and standalone health insurers to offer individual covid standard health policy called Corona Kavach Policy. Homecare treatment is covered under the Corona Kavach policy. As per the terms and conditions of the Corona Kavach policy, homecare treatment means undergoing the treatment for Covid-19 at home on the advice of a medical practitioner. Persons aged between 18 and 65 are eligible to opt for this policy. Dependent kid or kids shall be covered from day 1 up to 25 years of age. Insurers may also cover persons above 65 years of age as per the product design and underwriting policy of the company.
The Corona Kavach policy pays for doctor's consultation, treatment, and medical bills for up to 14 days. The cost of pulse oximeters and oxygen cylinders are also included. However, self-treatment or home quarantine without any doctor's consultation is not included. The minimum sum insured available is Rs 50,000 and the maximum limit goes up to is Rs 5,00,000. A person may choose any sum insured within these limits in the multiples of Rs 50,000.
On the other hand, the Corona Rakshak policy is a Covid-specific health insurance policy, which covers treatment costs, provided the policyholder has been hospitalised for a minimum of 72 hours continuously. The Corona Rakshak Policy covers other costs for purchasing mandatory equipment, which includes oximeters, masks, oxygen cylinders, oxygen nebulisers, PPE kits, and gloves for an individual. The policy can be availed by individuals aged between 18-65 years on an individual sum insured basis. The sum ranges from Rs 50,000 to Rs 2.5 lakh. People who have denoting medical conditions can get insured by paying an additional premium. An individual can get 100 per cent of the sum insured under the Corona Rakshak policy, in case of hospitalisation.
How can one claim for the reimbursement?
Initially, an RT-PCR test result should be provided to make a claim. Provide the reference number for future purposes. In case of a new policy, the patient will be eligible for the claim after the waiting period of 15-30 days, depending on the insurance company. It is mandatory to provide original Covid-19 medical reports, medical bills, prescriptions, consultation slips, diagnostic reports, pathology/radiology tests and identity proof should be provided at the time of the claim. After verifying the bills and other documents, the reimbursement will be made. Also, it is important to note that the policyholder should have an active insurance policy. It should have been paying the premium, on a regular basis and should not hide pre-existing diseases or produces fake bills.
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