While most health insurance policies in India are providing cover for the coronavirus infection, you may not be able to get a claim for its treatment in the following scenarios.
Your claim will also be limited by the maximum sum insured by your health insurance policy.
If you are not hospitalised for at least 24 hours
Health insurance claim due to coronavirus will be payable only if you are hospitalised for at least 24 hours. However, if you are not hospitalised, then your policy may not cover the claim as most of the indemnity type health insurance policies (mediclaim) in India do not cover outpatient treatment.
Shreeraj Deshpande, COO, Future Generali India Insurance said, “Any person who is hospitalised as a result of coronavirus and takes treatment will be covered as any other illness. The subsequent claims will be processed as per regular norms, provided the individual has been hospitalised for at least 24 hours.”
If the disease is declared as epidemic/pandemic
Your insurer might not settle a claim under your health insurance policy if the disease is declared as an epidemic or pandemic by the World Health Organization (WHO).
Subramanyam Brahmajoysula, Head – Underwriting and Reinsurance, SBI General Insurance said, “If coronavirus is declared as a pandemic by the WHO or Indian government, or both, then claims might not be payable as such claims are excluded under many health insurance policies.”