Corona Kavach Insurance

The COVID-19 pandemic has underscored the importance of having health insurance to avail medical treatment and to handle emergencies. The disease affects different people to differing extents; most might need professional medical assistance in hospital.

Timely medical attention can cure a coronavirus infection, but the cost of quality healthcare can be expensive. Tata AIG has launched the Corona Kavach Policy with the aim of making effective treatment for COVID-19 accessible to all. Read on for the details.

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Corona Kavach Covers

COVID-19 Hospitalization Cover: Medical expenses arising from hospitalization to undergo treatment on testing positive for COVID-19 in a government-authorised testing centre.

This benefit includes the following:

  • Room rent, bed charges, nursing fees, ICU/ICCU expenses
  • Consultation fees for specialist doctors, surgeons, medical practitioners, anaesthetists
  • Costs for blood, oxygen, anaesthesia, ventilator, operation theatre, surgical appliances
  • Medicines and drugs
  • Diagnostics, diagnostic imaging modalities, PPE kit, gloves, and mask

Claim is admissible only if the hospitalization is for at least 24 consecutive hours.

Road ambulance: Cost of road ambulance service availed for COVID-19-related hospitalisation.

  • Up to Rs 2000 per hospitalisation
  • Includes transportation from one hospital to another under advice from a medical practitioner

Home care treatment Expenses: Treatment taken at home for up to 14 days after a positive COVID-19 diagnosis at a government authorised diagnostic centre. This cover is subject to the following:

  • Medical practitioner’s advice for home treatment
  • Continuous active treatment with daily monitoring by a medical practitioner
  • Maintenance of daily monitoring chart with treatment records, duly signed by the attending physician

Coverage includes medical investigations as per treating healthcare practitioner’s prescription related to COVID-19, prescribed medicines, doctor’s consultations, parenteral administration of medicines, nursing costs, and cost of oxygen cylinders, oximeters, and the nebulizer.

AYUSH treatment: Inpatient treatment costs under Ayurveda, Yoga and Naturopathy, Unani, Siddha, and Homeopathy, following a positive diagnosis of COVID-19 at a government authorised diagnostic centre.

Pre-Hospitalization: Pre-Hospitalization/home care treatment medical costs incurred for up to 15 days before hospital admission/home care treatment starting date.

Post-Hospitalization: Post-Hospitalization/home care medical expenses for 30 days from the date of discharge from the hospital/completion of home care treatment.

Add-on benefits: You can extend your coverage with the optional Hospital Daily Cash add-on at a nominal price. This benefit helps you save on your day-to-day healthcare spends. It offers 0.5% of the sum insured per day for 24 hours of continuous hospitalisation due to COVID-19 and is payable for up to 15 days in a policy period.

For further details on coverage, exclusions and terms & conditions please refer policy wordings

Corona Kavach - Discounts available

Avail attractive discounts to cover your entire family against COVID-19 with a family floater plan.

The discount can vary from 15% (2 members) to 20% (3 members) to 25% (more than 3 members).

Healthcare workers are eligible for a special premium rate that offers an additional discount of 5%

Corona Kavach - Eligibility Criteria

Age limit for adults: 18 (minimum) to 65 (maximum) Dependent children: 1 day (minimum) to 25 years (maximum)

Note: Proposers older than 65 can buy the policy for dependent family members without getting the cover for self.

Family members permitted under the family floater plan: Legally wedded spouse, parents and parents-in-law, natural or legally adopted children (provided the children over 18 are not financially independent).

Corona Kavach - Claim Procedure

Cashless claim process

  • Treatment may be taken in a network provider and is subject to pre authorization by the Company or its authorized TPA.
  • Cashless request form available with the network provider and TPA shall be completed and sent to the Company/TPA for authorization.
  • The Company/ TPA upon getting cashless request form and related medical information from the insured person/ network provider will issue pre-authorization letter to the hospital after verification.
  • At the time of discharge, the insured person has to verify and sign the discharge papers, pay for non-medical and inadmissible expenses.
  • The Company / TPA reserves the right to deny pre-authorization in case the insured person is unable to provide the relevant medical details.
  • In case of denial of cashless access, the insured person may obtain the treatment as per treating doctor’s advice and submit the claim documents to the Company / TPA for reimbursement.

Reimbursement claim process

For reimbursement of claims the insured person may submit the necessary documents to TPA (if applicable)/Company within the prescribed time limit as specified hereunder.

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Exclusions

Corona Kavach Exclusions

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The Company shall not be liable to make any payment under the policy, in respect of any expenses incurred in connection with or in respect of:

Investigation & Evaluation: Expenses related to any admission primarily for diagnostics and evaluation purposes. Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment

Rest Cure, rehabilitation and respite care: Expenses related to any admission primarily for enforced bed rest and not for receiving treatment. This also includes: i. Custodial care either at home or in a nursing facility for personal care such as help with activities of daily living such as bathing, dressing, moving around either by skilled nurses or assistant or non-skilled persons. ii. Any services for people who are terminally ill to address physical, social, emotional and spiritual needs.

  • Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a medical practitioner as part of hospitalization claim or Home care treatment.
  • Unproven Treatments: Expenses related to any unproven treatment, services and supplies for or in connection with any treatment. Unproven treatments are treatments, procedures or supplies that lack significant medical documentation to support their effectiveness. However, treatment authorized by the government for the treatment of COVID shall be covered.
  • Any claim in the relation to COVID where it has been diagnosed prior to policy start date
  • Any expenses incurred on Day Care treatment and OPD treatment
  • Diagnosis /Treatment outside the geographical limits of India
  • Testing done at a Diagnostic centre which is not authorized by the Government shall not be recognized under this Policy
  • All covers under this Policy shall cease if the Insured Person travels to any country placed under Travel restriction by the Government of India.

For further details on coverage, exclusions and terms & conditions please refer policy wordings

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