ARTICLES

With the alleged second wave of the virus infecting lakhs of people, the cases of hospitalization have increased nationwide. More and more people are showing signs of severe infections and are being hospitalized. Hospitalization involves a considerable amount of medical costs. Do you know you can claim such costs in your health insurance policies?

There are three instances of coverage wherein claims for COVID are available. They are as follows –

• A normal indemnity health insurance plan that covers hospitalization costs. However, remember that such plans do not cover home quarantine costs unless specified.
   
• Corona Kavach policy covers both the costs of hospitalization and home quarantine without any deductibles.
   
• Corona Rakshak policy gives a lump sum benefit if you are hospitalized for 72 hours or more due to COVID.

Claim process
Here’s how you can claim from the afore-mentioned policies – For policies 1 & 2, i.e. a normal health plan and Corona Kavach – 

• Inform the company immediately of being infected with COVID.

• If you seek hospitalization in a networked hospital, fill up and submit a pre-authorization form at the insurance desk in the hospital or send it to your insurance company directly. This form should be filled and submitted at least 2-3 days before a planned hospitalization and within 24 hours of emergency hospitalization.

• Based on the pre-authorization form, cashless approval would be allowed. You can take the treatments and the hospital bills would be settled by the insurance company directly.

If you are hospitalized in a non-networked hospital or if the cashless approval is delayed, the claim can be settled on a reimbursement basis. You would have to bear the medical costs yourself when you are hospitalized. Thereafter, once you are discharged and recovered, fill up the claim form and submit all the original medical bills and reports. The insurance company would reimburse you for the costs incurred.

For Corona Rakshak policy, which is a fixed benefit plan, fill up the claim form and submit all medical reports to the insurance company. The company would assess the documents and pay the sum insured in lump sum irrespective of the actual medical costs that you have incurred.

Things to remember

• In the case of normal health plans, the cost of consumables might not be covered under the policy. You would have to pay such costs out of your pockets while the insurer would settle the remaining claim.

• No deductibles are applicable in a Corona Kavach or Corona Rakshak plan. However, there is a waiting period of 15 days from the policy purchase date during which COVID claims are not covered.