HEALTH INSURANCE-COVID 19

Benefits

If a person is first diagnosed with COVID-19 during the policy period, we will pay the entire Sum Insured, as specified in the Policy Certificate against this cover, as a lump sum amount.

Value Added Services

Health Assistance 
The insured person can reach our health assistance team via a dedicated helpline and get help for the following: 
• Identifying specialist/ Hospital
• Fixing an appointment with Medical Practitioners wherever applicable on best effort basis
• Providing options on suitable Network Providers
• Providing information on ailments and possible lines of treatment
• Providing for a second opinion

CHAT /Virtual Consultation
The insured person can also take the help of our virtual consultation service to reach out to healthcare professionals for assistance:
• For routine health query, service can be availed during official hours Monday to Sat (excl. public holidays).
• We will only be arranging to provide consultation. Any treatment, medication or investigation advised by the medical practitioner shall not be borne by the company.
There is no restriction on the number of times the health assistance service and CHAT can be availed.

Additional Coverage

The COVID-19 protection cover also comes with certain add-ons that can enhance the coverage provided to the insured.

• Tele Consultation: 4 free calls to take any consultation with certified medical practitioners available on call 24 hrs., 365 days
• Ambulance Assistance: We will provide assistance in arranging for an ambulance in case of any medical need. The service can be availed unlimited number of times. The cost of transportation will have to be borne by the insured.

Conditions for claim eligibility

• The diagnosis must be confirmed by only those specific test(s) as defined by government authorities
• The test for Novel Corona virus should be conducted in National institute of virology, Pune or any other Government designated laboratory in India, appointed for testing of COVID-19
• The lab diagnosis must have been performed after the initial waiting period of 14 days.

Exclusions:

• Any travel history post Dec 31, 2019, to any affected area overseas
• Any history of quarantine or diagnosis with COVID-19 prior to the risk inception or within the waiting period of 14 days
• Any claim within first 14 days after policy inception

Documents Required

In the event of a claim, we must be intimated immediately but no later than 30 days from date of event/diagnosis. We must receive below mentioned mandatory documents for claim processing

• Duly filled claim form by the Insured Person/claimant.
• Lab report with sign and stamp, confirming positive for Corona virus.
• The insured must have been tested positive for COVID-19 in National Institute of Virology, Pune or any other Government authorised laboratory in India.
• Certificate from Government medical officer confirming diagnosis or from any medical practitioner authorised by government to issue such certificates
• Declaration of “No travel” post 31 Dec 2019, (format will be shared shortly)
• Any treatment papers, Doctor’s Certificate, Discharged Summary, other Investigation reports
• Cancelled cheque and NEFT mandate form - duly filled in by the Insured Person/claimant

Terms & Conditions

• Waiting period: Initial Waiting period of 14 days (Not applicable to VAS or Add on coverage)
• Age: 18-75 yrs
• No survival period
• 1 year policy period
• The scope of cover shall be within the geographical boundaries of India and restricted to Indian nationals only

Frequently Asked Questions

• What is coverage under the policy?
  First diagnosis of COVID-19. This includes value added services like Health assistance benefit and chat/virtual consultation. There is an add-on coverage which includes tele consultation and ambulance assistance
• Do you pay only in case of hospitalisation due to COVID-19?
  No, we will pay entire Sum Insured on first diagnosis of COVID-19, irrespective of hospitalisation. 
• What is the policy period?
  Policy Period is 1 year 
• Is there any waiting period applicable to the policy?
  Waiting Period is of 14 days 
• What is Survival period?
  Survival period means the minimum no. of days insured has to be alive post the diagnosis to avail the Benefit 
• Is survival period applicable under the policy?
  No, there is no survival period. 
• Is it indemnity cover or a benefit cover?
  It is a benefit policy. 
• What is Benefit cover?
  It is a cover where we pay the entire Sum Insured(usually as a lump sum) once the insured event is triggered 
• What is minimum age eligibility for the product?
  Minimum age -18 years. 
• What is maximum age eligibility for the product?
  Minimum age -75 years. 
• Are OPD expenses or hospitalisation expenses covered under the policy?
  No, we donot reimburse OPD/Hospitalisation bills. In the event of diagnosis due to COVID-19 we pay the entire Sum Insured provided to you irrespective of your bills 
• Can a Foreign passport holder avail this cover when in INDIA?
  Only Indian passport holders residing in India can be covered. 
• Does the product have worldwide coverage?
  No the coverage is limited to geographical boundaries of India 
• If a Person is already diagnosed with COVID- 19, can he still avail the product?
  No. 
• Any overseas ravel history of the insured post December 31, 2019, can we cover him?
  No. 
• If person diagnosed with COVID-19 prior to the risk inception date or within the initial waiting period of 14 days, will we pay him?
  NO, if the insured has been quarantined for suspected COVID-19 or diagnosed with COVID-19 prior to the risk inception date or within the initial 14-Day waiting period claim will not be paid .