Recently, the Insurance Regulatory and Development Authority of India (IRDAI) released draft guidelines for the launch of standard health insurance products for vector-borne diseases by health & general insurers. These diseases include malaria, dengue, chikungunya, kala-azar, filaria, Japanese encephalitis, and zika virus.
Insurance companies can offer anyone or any one or a combination of the vector-borne diseases and can price a policy for every covered disease respectively. These policies can have a waiting period of fifteen days and the premium will be on a pan-India basis and no zone-based pricing has been permitted.
Amit Chhabra, head, health insurance said “Vector-borne diseases such as dengue & malaria have always been common in India, however people take it lightly in the initial phase. The cost of treatment for dengue can vary anywhere from Rs 25,000 to Rs.70,000. Therefore, having a vector-borne disease plan in the plan will help customers protect themselves from against these diseases.”
A standard product means that the coverage for a particular policy is unvarying among all insurance companies. However, IRDAI has not made it binding to launch standard health products include Corona Kavach & Rakshak for Covid-19, Aarogya Sanjeevani, which is a health plan, and Saral Jeevan, a term insurance policy. Life insurers have been mandated by IRDAI to launch Saral Jeevan products by Jan 01, 2021.
IRDAI said that “the insurers can propose two optional covers along with the standard product.” The base cover of a standard product for vector-borne diseases should be offered on an indemnity basis (reimburses expenses incurred during hospitalization) and optional covers shall be offered on a benefits basis (payout is fixed).
The minimum sum insured has been kept at Rs 10,000, while customers opt for the cover in the multiples of Rs.10,000 up to Rs. 2 Lakhs. The product can be offered on a family floater basis as well.
India has recommended that the product will be offered for a fixed term of one year. However, it’s looking for suggestions on whether this product should be offered for a shorter-term (less than one year), as vector-borne diseases are normally seasonal.
Expenses for room, boarding & nursing have been limited at 2% of the sum insured above Rs. 20,000 and charges for Intensive Care Unit (ICU) have been limited at 5% of the sum insured above Rs 20,000. Road ambulance charges have been limited at Rs 2000 per hospitalization. These policies will also cover the expenses under the Ayush treatment.
All medical expenses incurred for a period of 15 days prior to the date of hospitalization will be covered, while post-hospitalization expenses incurred 30 days after the date of discharge from the hospital will be admissible under the cover. The policy doesn’t allow any deductibles- an amount insured must pay from his/her pocket before the insurer pays towards the policy coverage.
