Who should opt for indemnity-type Covid Kavach health insurance (2024)

As protection against the raging Covid pandemic, insurance regulator, Irdai, had directed all general and health insurers, on 26 June 2020, to come up with two standard Covid-specific plans—Covid Kavach and Covid Rakshak—by 10 July. While the mandatory Covid Kavach is an indemnity plan which pays for hospitalisation, Covid Rakshak is optional and a benefit-based plan, which means you get a lump sum on diagnosis from a government authorised diagnostic centre and on continuous hospitalisation of 72 hours. Some insurers have already brought out the products, while others are set to launch shortly.

Given the fact that there already exist in the market basic health plans covering the disease as well as Covid-specific plans, what was the need for another exclusive indemnity plan to cover Covid? More importantly, what should customers do?

“Covid Kavach is not only standardised, which means its features are uniform across insurers, but is also a more comprehensive version of the existing Covid plans. This is because it also covers homecare, PPE and treatment of co-morbidities when hospitalised,” says Gurdeep Singh Batra, Head, Retail Underwriting, Bajaj Allianz General Insurance. Since these are not covered by basic health plans, you may end up paying from your own pocket. The plan also covers ventilator and ICU charges, as well as the cost of oximeter and oxygen cylinder.

Secondly, the average size of health plan that people have is Rs 3-5 lakh, which may not be adequate for high costs of Rs 10-15 lakh involved in the treatment of Covid. “Besides, Covid is very contagious and the entire family may be affected. In such a case, the low cover will not be able to take care of even a single person, let alone all the family members,” says Bhabatosh Mishra,Director, Claims, Underwriting & Product, Max Bupa Health Insurance.

Since everyone may not have a high and a comprehensive cover, or may not be able to afford the high premium, or may have no health insurance at all, Kavach may be a good option to cover the enhanced risk in the current circ*mstances. With the Covid cases increasing at a fast pace, especially in bigger cities and metros, it may serve as an effective intermediary plan for the short term of 3-9 months. Besides, it can be used in combination with basic plans to increase the overall cover size. For instance, if you have a Rs 5 lakh basic plan that covers Covid, you can take a Rs 5 lakh Kavach plan to enhance your cover size to Rs 10 lakh.

As for Covid Rakshak, which offers a lump sum, it can be especially useful in case of home isolation and treatment because you can spend the money at will on medicine, treatment or nursing charges. Remember, however, that the maximum cover offered under Covid Rakshak is Rs 2.5 lakh as opposed to Rs 5 lakh for Kavach. “Also keep in mind that Kavach is only an ancillary product for a single disease and cannot be a replacement for the more comprehensive basic health plan,” says Mishra. So, you can use it to augment a basic plan or buy it if you have no plan at all, but after the risk has reduced, purchase an indemnity plan, which can even be Arogya Sanjeevani whose cover size has now been enhanced.

The premium rates available to ET Wealth at the time of filing the story seem reasonable and affordable, with Max Bupa Health Insurance charging a 35-year-old man Rs 3,260 for a Rs 5 lakh cover for a term of 9.5 months. Star Health & Allied Insurance, on the other hand, has set the premium for the age band of 0-45 years at Rs 5,172 for a Rs 5 lakh cover for a tenure of 9.5 months. The plans are also available for terms of 3.5 months and 6.5 months, which include a 15-day waiting period, when no claim will be entertained.

Covid Kavach & Covid Rakshak

Who should opt for indemnity-type Covid Kavach health insurance (1)

Ceiling removed for Arogya Sanjeevani plan

Insurers can now offer covers higher than Rs 5 lakh and lower than Rs 1 lakh, but will the pricing remain as attractive as before?

The Insurance Regulatory and Development Authority of India (Irdai) has removed the upper and lower limits of the Arogya Sanjeevani standardised health insurance plans. The indemnity product was launched in April with a minimum cover of Rs 1 lakh and a maximum of Rs 5 lakh. These limits have now been removed, which could be a gamechanger for the low-cost standardised plans.

The move may be a way to provide easier access to higher covers given the large costs involved in Covid treatment. “After the pandemic outbreak, the cost of hospitalisation, especially in bigger cities, is becoming high and one should have an ideal cover of Rs 10-15 lakh. Taking cognisance of this, the regulator may have decided to increase the limit,” says Anand Roy, MD, Star Health & Allied Insurance.

A big pull factor for the plan was its low premium compared with similar plans in the market. Will this continue for bigger covers? Roy is confident the premium will continue to be lower than other plans. Agrees Sanjay Datta, Chief Underwritings, Claims and Reinsurance, ICICI Lombard: “Since the caps and limitations will remain in place, the premium should be lower than similar market plans.”

Others, however, are not so sure. “As the product was launched in the pre-Covid period, the potential impact of Covid has not been factored into the pricing. If the product has to be re-priced taking this into consideration, the premium may go up,” says Bhabatosh Mishra, Director, Claims, Underwriting & Product, Max Bupa Health Insurance. It may not be possible to keep the Rs 1-5 lakh products at the pre-Covid price and those above Rs 5 lakh at new price points. “It will be a challenge to reconcile the two pricings,” says Mishra.

As increasing the cover size is not mandatory, all insurers may not do so. Even though Star Health has decided to come out with higher covers before next month, others are waiting to gauge the demand. The extent to which the cover size will be enhanced is also not certain. “We may increase it by Rs 2-3 lakh, certainly not go up to Rs 50 lakh. We will take a decision depending on the demand for higher insurance covers,” says Datta.

If the premium remains low, it will be a good product since it is standardised and comprehensive despite the caps. But if the premium is comparable with other plans, the buyer may get better and more comprehensive plans without caps. Instead of buying a bigger cover just for Covid-related expenses, it may be better to opt for the new Covid-specific plan, which covers equipment and homecare treatments. If the need is just for a bigger base cover, wait for a couple of months before you take a decision.

Who should opt for indemnity-type Covid Kavach health insurance (2024)

FAQs

What is the disadvantage of indemnity health insurance? ›

It doesn't cover prescription drugs and typically won't work for those with pre-existing conditions. Coverage is not guaranteed and there will be limits, which vary from one plan to another.

What is the difference between a PPO and an indemnity plan? ›

Unlike managed care plans, such as HMOs or PPOs, which require individuals to select healthcare professionals from within a predefined network, indemnity plans allow you to access care from any licensed provider or facility across the country.

What is indemnity in health insurance? ›

With indemnity plans, the insurance company pays a pre-determined percentage of the reasonable and customary charges for a given service, and the insured pays the rest. With an indemnity plan, there's no provider network, so patients can choose their own doctors and hospitals.

Which form of health insurance based benefits on the indemnification of the insured? ›

Fixed indemnity insurance is a type of health insurance that pays out a fixed benefit for each healthcare event, regardless of the actual costs insured. A fixed indemnity plan might pay a certain amount of money for each hospital admission, or a certain amount for each day of hospitalization.

Does everyone need indemnity insurance? ›

Is professional indemnity insurance a legal requirement? PI insurance is not a legal requirement. However, if your profession is deemed high-risk, some professional bodies, governments and clients may request you have a minimum level of cover before allowing you to operate or doing business with you.

Is indemnity health insurance worth it? ›

For those with chronic medical conditions — like cancer, diabetes, or heart disease — hospital indemnity insurance can help cover your frequent hospital visits. You have an upcoming surgery or procedure. You may want hospital indemnity insurance for a scheduled hospital visit, overnight stay, or outpatient surgery.

What is the advantage of choosing an indemnity plan over a managed care plan? ›

Indemnity plans do give you more freedom, however, than managed care plans in terms of using the healthcare provider of your choosing. So, as with anything else, the choice between managed care and indemnity plans ultimately depends on your personal circ*mstances and preferences.

What are the three types of indemnity plans? ›

What Are the Types of Indemnity Plans?
  • Accident fixed indemnity.
  • Critical illness coverage.
  • Hospital sickness coverage.
May 21, 2022

Why indemnity insurance? ›

Professional indemnity insurance protects you against claims for loss or damage made by clients or third parties as a result of the impact of negligent services you provided or negligent advice you offered.

Do indemnity plans cover Medicare deductible? ›

Hospital Indemnity insurance can offer protection in a variety of ways for Medicare Supplement policyholders: Hospital Indemnity covers the deductible if you're in a high-deductible plan.

What's the difference between indemnity and insurance? ›

Both indemnification and insurance transfer risk and guard against financial losses, but they do so differently: Indemnification transfers risk between contracting parties through a non-insurance agreement. Insurance transfers risk from one party to another in exchange for payment.

Who is the largest HMO in the United States? ›

1. UnitedHealth Group. UnitedHealthcare, part of UnitedHealth Group, is the largest health insurance company based on revenue. UnitedHealthcare offers a variety of products from individual health insurance to employer plans for some of the biggest corporations.

Why is indemnity bad? ›

Why are indemnity clauses misused? Indemnity clauses are most commonly misused for two reasons: That if a risk is not covered by an indemnity, a party will not have adequate means of recovering its loss if the risk materialises.

What are the disadvantages of the indemnity clause? ›

Aside from difficulties associated with the clarity of meaning and operation of such clauses, two common problems encountered are: the party giving the indemnity does not have the financial capacity to fund the loss; or. the party giving the indemnity is exposed to an uninsured liability.

What are indemnity risks? ›

Specific indemnities

loss or damage to third party property or persons in carrying out the works; breaches under the Bribery Act; breaches of confidentiality undertakings or data protection; liability caused as a result of actionable nuisance and trespass claims; and/or. infringements of environmental law.

What do indemnity plans usually reimburse? ›

The plan will pay for charges for medical tests and prescriptions as well as from doctors and hospitals. It may not pay for some preventive care, like checkups. With Indemnity health plans, the insurer only pays for part of your doctor and hospital bills.

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