In a fresh set of guidelines, the Insurance Regulatory and Development Authority of India (Irdai) has asked general and stand-alone health insurers to offer two products specific to Covid-19 by July 15.
One will be indemnity-based (standard health policy), and the other a benefit-based product (standard benefit-based policy).
Though the policy wordings and benefits received will be uniform across all insurers, the pricing has been left to insurers. Experts say the standard product will be cheaper than other comprehensive health products, while the benefit-based product will be priced higher than the indemnity one. “The benefit-based product will have a higher premium for the same sum assured,†said Sanjay Datta, chief (underwriting and claims), ICICI Lombard.
“The logic behind the two products is: If anyone has a normal health product, then may take the benefit-based product and on testing positive, will get a lumpsum amount. The benefit-based product may be taken as a supplementary. However, if you do not have such a product, then opting for the indemnity-based product makes sense,†he added.
ALSO READ: Hospitals rework Covid-19 narrative as pandemic takes toll on trust, biz
Earlier, the regulator had explored the idea of an indemnity-based product from June 15, but altered the guidelines and asked insurers to offer a benefit-based product by June 30.
In view of the new guidelines that the regulator has come up with, the standard health policy for will come with a base cover that is indemnity-based, and an optional cover that is benefit-based. It will be offered for a tenure of three, six, and 12 months, with maximum sum assured of Rs 5 lakh (minimum being Rs 50,000). The base cover will take care of hospitalisation expenses for treatment after detection through a government-approved diagnostic centre. The base cover will not have any ceiling on room tariffs, ICU expenses, and will cover the cost of PPE kits and masks.
Ambulance costs have, however, been capped at Rs 2,000. The base cover is also supposed to include home care expenses, if the insured person is advised to undergo home treatment. The optional cover will pay 0.5 per cent of the sum assured per day, for every 24 hours of continuous hospitalisation. The benefit shall be payable for a maximum of 15 days. As regards the standard benefit-based policy, a lumpsum amount equal to the sum assured shall be payable on positive diagnosis, requiring hospitalisation for a minimum of three continuous days. The policy will have minimum sum assured of Rs 50,000 and maximum of Rs 3 lakh.
