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The newly discovered and highly contagious disease COVID-19 has taken the world by storm. Assumed to have originated from the wet markets of Wuhan, China, the virus has impacted over 1.4 million people across 184 countries as per official records.

The lack of specific vaccines and treatments for the virus is the reason for the global frenzy and therefore, getting through the pandemic safely is the need of the hour for all humankind.

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Amidst the apprehension and uncertainty concerning the present scenario, we must evaluate the risks and assess if the worst comes to pass. Evaluating the risk also involves creating enough financial contingency to pay off if you fall prey to the virus. Whether or not your standard health insurance covers COVID-19 is a common dilemma. Therefore, it is imperative to know if you are covered in case you succumb to the virus.

Let’s know the details on whether our standard health insurance covers COVID-19.

Measures Taken by The IRDAI

The Insurance Regulatory and Development Authority of India has taken some immediate decisions on the insurance coverage to be provided by the insurance companies. As per the orders of the IRDAI, all claims related to Coronavirus must be handled by all insurance companies. The expenses in regards to treatment and hospitalization of those affected by the Coronavirus must be covered by their respective insurance houses, including those in quarantine.

It is certain that any standard health insurance will cover the expenses incurred towards hospitalization and treatment of the viral infection. However, now that the novel Coronavirus has been declared a pandemic by the World Health Organization, there may be a cut down in insurance plans covering for expenses towards the treatment and hospitalization.

Since many standard health insurance plans have coverage exclusions in the event of a pandemic, the insured may be left stranded without proper coverage for the disease which makes looking out for a Coronavirus-specific insurance coverage imperative. It is, therefore, advised to go through the inclusions and exclusions of your health insurance plans or you can check with your insurance service provider on whether you are covered for the virus.

What if You Test Positive For The Virus?

Currently, India is about to enter the third stage of the pandemic which indicates that the cases of community contagion have started taking place. The spread of the virus is no longer limited to individuals with a history of international travel. Individuals with no history of international travel stand equally at risk of contracting the virus which makes it essential for everyone to have complete knowledge on whether their insurance covers for the virus or not.

As per the circular issued by the IRDAI, insurers must cover the expenses for the treatment of an insured that is tested positive for the virus. The expenses while in quarantine must also be covered by your standard insurance plan.

Does Travel History Impact The Approval of Insurance Claim?

Insured individuals with the history of international travel may wonder whether they are eligible to receive their insurance claims should they test positive for the virus. Whether your claim (in standard health insurance) is approved by your insurance service provider has a little to do with your travel history. Your insurer may ask for your travel history in order to collect relevant data for internal purposes but it does not impact the disbursement of the claim.

Need-based Policies

The IRDAI has stated the need for insurance service providers to design insurance plans specific to Coronavirus. The need-based policies are characterized by guaranteed disbursal of 100% sum assured. Under Coronavirus-specific insurance plans, the insured can claim the sum assured right after being tested positive. The plan terminates after the claim is made. However, quarantined individuals are eligible to receive only 50% of the sum assured which, therefore, accounts for the loss of income. 

Need-based policies have a notable restriction. To be able to file a claim, you must be hospitalized for at least 24 hours. Some policies also include OPD expenses. The plans also come with a plethora of terms and conditions. For instance, a person who displays symptoms similar to the symptoms of a virus-infected person for the last six weeks of purchasing the policy will not be eligible to receive the sum assured. Also, the insured must not come in contact with anyone who is tested positive for the virus or who is suspected of having a history of COVID-19.

Another notable exclusion that must be considered before buying the Coronavirus insurance pertains to the travel history of the insured. The insured or his/her immediate family members must not have traveled to countries like China, Hong Kong, Thailand, Japan, Singapore, Malaysia, Italy, Bahrain, Kuwait, Taiwan, Macau, and Iran after December 1, 2019.

There are a bunch of other exclusions that must be reviewed and considered before making the purchase. Ensure that you enquire about your insurance agent or your insurance service provider about the terms and conditions before purchasing the policy.

Naval Goel is the founder of He is an Associate Member of the Indian Institute of Insurance`, Pune. He has been authorized by IRDA to act as a Principal Officer of Insurance Web Aggregator.
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