5 Things to Know While Filing a Health Insurance Claim for COVID-19

The coronavirus pandemic or as popularly known as COVID-19 pandemic has taken the world by a storm. The entire globe witnessed lockdowns in different parts of the world that brought the economies of the country to a standstill. Although having a financial impact, it also strengthened the importance of having a health insurance policy.

A health insurance plan provides us with much needed financial as well as mental security at times of medical emergencies. The regulator, Insurance Regulatory and Development Authority of India (IRDAI) ensured all health insurance policies that included hospitalisation benefits offer coverage for coronavirus treatment. Thus, many individuals continued to buy health insurance plans to ensure a safety net for their medical expense.

But do you know what to consider when claiming COVID-19? In this article, we have compiled five things that you should know about coronavirus claims –

#1 Waiting period for your policy

If you have purchased a new health insurance policy to protect against coronavirus, you should inquire about the waiting period for your policy. Most insurance policies have specified days of waiting period after which claims can be admitted. Similarly, for COVID-19 treatment, you should read the policy terms that mention the waiting period.

#2 Test yourself only at authorised medical facilities

A laboratory test is necessary to determine whether you have contracted the novel coronavirus. The Indian Council of Medical Research (ICMR) has authorised certain testing facilities in this regard. Thus, when you file an application for the claim, make sure you have tested only from an authorised testing facility. Alternatively, to increase the testing throughout the nation, private labs conduct the test only when prescribed by a physician as per the ICMR guidelines.

#3 Verify the nature of the treatment covered

A few private hospitals offer home-care treatment packages for COVID-19. In case you or your family is recommended this mode of treatment, verify whether your insurance company covers it. Some insurers offer cashless health insurance plans. You should confirm with your insurer whether a cashless facility is available for the type of treatment you are availing, i.e. home care, quarantine or treatment in a hospital.

#4 Submit pre and post hospitalisation expenses

Generally, health insurance plans cover pre as well as post hospitalisation expenses. Apart from these charges, ambulance charges, testing costs are also covered by your insurance policy. Ensure you submit all relevant documents that are supporting your claim.

#5 Get your discharge summary

Insurers are offering coronavirus policies as an altogether separate plan. This way, you can purchase a COVID-19 cover over and above your standard health insurance plan. While you have two policies that cover COVID-19 treatment at the same time, you can take advantage of higher sum insured offered by the different plans. For this, you will require a discharge summary that bifurcates the treatment cost.

Lastly, elderly individuals are more prone to this virus due to their weaker immune systems. To make sure they have adequate medical protection, health insurance for senior citizens can be helpful. Any unexpected treatment cost for elderly individuals can be insured using senior citizen cover.

Remember these five tips to ensure you have hassle-free claim experience. Whether you purchase a COVID-19 specific policy or already have health insurance, make sure you inform your insurer when diagnosed. It will help them speed up your claim settlement process.


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