The COVID-19 pandemic has been an eye-opener for several reasons, but at the same time it also made us realise the importance of having health insurance. Health insurance gives us the much needed mental and financial security when we encounter a medical crisis. Many people had health insurance plans before the pandemic's breakout, and many took post spread of the disease. But most of them are unaware of the procedure and requirements to file a COVID claim.
It is important to be well informed about COVID-19 related claim settlement procedures so that if you or family members are tested positive, you are not running around but concentrating on your or family’s well-being. Here are five things you must know about COVID-19 claims:
Laboratory tests are necessary to determine the presence of novel coronavirus in the respiratory system. There are government-designated labs and private labs approved by the Indian Council of Medical Research (ICMR) to conduct COVID-19 tests in India. The private labs will test only when prescribed by a qualified physician per the ICMR guidelines. When you are filing for the claim, make sure you submit the test report obtained from a government authorized laboratory along with a proper prescription from a qualified physician recommending the test to avoid any inconvenience later.
Some private hospitals have started offering home care packages for COVID-19 treatment. If your medical practitioner recommends this mode of treatment for you or your family members, then inquire with your insurer whether they cover home care costs. As a general rule, a regular, indemnity-based health policy reimburses the hospitalisation expenses as well as listed day-care procedures up to the sum insured. The insurer should be informed about the nature of treatment undertaken – whether it is under home care, quarantine, or treatment in a hospital to avoid any confusion during reimbursement. The insurer will assess the claim as per the terms and conditions of the policy the insured is covered under.
As per your policy, you are covered against pre and post hospitalisation expenses, ambulance charges, and treatment expenses for coronavirus related symptoms. Ensure that you submit all consultation papers before hospitalisation and follow up treatment after discharge along with bills.
Nowadays, people are buying COVID policies in addition to their existing health policy. It gives the policyholder the benefit of filing claims on one or more policies. If the claim is under a benefit policy that has a higher benefit for ICU admission, the discharge summary must specify the number of days spent in the ICU and a standard room.
Whether you choose a COVID-19 specific policy or a comprehensive health insurance plan, or even if you already have a health insurance policy, make sure to inform your insurance provider if you happen to be diagnosed with coronavirus. It will help them to address and settle the claim quickly.
The author is Chief Operating Officer, Future Generali India Insurance