COVID 19 brought forth an unprecedented health crisis in the world. While medical professionals immediately sprung to action to save lives, many people found themselves falling short of funds for treatment. This brought to light the many gaps in existing health coverage – plans that were designed pre-COVID 19 were simply not equipped to deal with the current scenario that required coverage to be revised. Moreover, many people simply had absolutely no health insurance at all.
In order to deal with the situation, the IRDAI launched two major types of health insurance plans – the Corona Kavach Policy and Corona Rakshak Policy. The terms of coverage offered under these two plans have been kept uniform across insurance companies so that everyone can purchase medical insurance minus the confusion of making a choice between plans.
In this article, we will take you through the process of filing a health insurance claim for a COVID 19 policy.
Claims under COVID 19 health insurance
As soon as you receive the report that you have been diagnosed as COVID 19 positive, you need to inform your insurance provider. Remember that your COVID 19 test must be done at a government-authorized center. The claims will be honoured upon admission to a hospital or even a government approved set-up (make-shift treatment centre) for COVID 19 cases.
Most leading health insurance providers offer multiple channels for you to be able to connect with them. You can reach out to your insurance company via their toll-free number to discuss your need to raise a claim.
Depending on the type of coverage you have – indemnity or benefit – the validity of your claim will be analysed and further processed.
Now, if you have a Corona Rakshak Policy, you get paid a lump sum after you prove that you require hospitalisation for at least 72 continuous hours or more. You can use this lump sum amount to pay your hospital bills, buy medicines, and for any other expense that arises due to your condition.
If you have a Corona Kavach Policy, your treatment is either cashless at a network hospital or reimbursed for a non-network hospital or availing treatment at home. For cashless hospitalisation, the exchange of documents usually happens directly between the hospital and the insurance provider. If you need to file for reimbursement, you will need to provide the documents to your insurance company to file a claim.
As part of your COVID 19 health insurance claim, you will be required to submit certain documents. These include identity proof and a copy of your health insurance policy. If you are filing for reimbursement after having completed your treatment, you must produce all copies of your hospital bills, diagnosis tests, and any other paperwork that shows you underwent treatment for COVID 19.
Do make sure to speak to your insurance company before filing a claim to make sure that you have all the required documents that they need for a smooth claim process.
This is an overview of the main points you need to know about filing a claim under a COVID 19 health insurance policy.