Now Both Arogya Sanjeevani Policy And Corona Kavach Policy Available As Group Insurance
IRDAI announced standard COVID-specific health insurance policies in April. At the time of the announcement, the Arogya Sanjeevani policy And Corona Kavach health insurance policy were only for individual coverage. But in July, IRDAI announced that the health insurance benefits of Arogya Sanjeevani policy And Corona Kavach health insurance policy can be availed for group coverage.
As the policies cover Covid-19, the group policies will be useful for various private and public companies for covering their employees’ medical needs. Earlier the insurance regulator had made it mandatory for all general and health insurance companies to offer Arogya Sanjeevani policy. Later it allowed the insurance companies to offer the same policy even as a group product.
Arogya Sanjeevani policy
Arogya Sanjeevani policy is a standard individual/group health insurance policy. The standard health insurance policy offers individuals and families coverage for hospitalisation-related basic expenses.
IRDAI issued a circular on July 7, 2020, allowing health insurance companies to offer Arogya Sanjeevani policy for a sum insured between Rs 50,000 and Rs 5 lakh. The Arogya Sanjeevani policy offers a basic health cover of a minimum sum insured of Rs 1 lakh.
The IRDAI issued another circular on July 24 that stated that insurers can offer the same standard policy as a group policy under the same name of Arogya Sanjeevani. All the terms and conditions of the policy were retained except the premium. The premium is to be fixed by the insurers. Among other things, the Arogya Sanjeevani policy covers the treatment cost of Covid-19.
The Arogya Sanjeevani group policy is assumed to provide protection and cater to the medical needs of a large number of employees working in manufacturing, services, logistics sector, SMEs, MSMEs, and migrant workers. It was clarified that Arogya Sanjeevani policy, in both individual and group forms will cover Covid-19.
On July 21, IRDAI directed general and life health insurance providers to offer Corona Kavach health insurance policy as a group insurance product.
Arogya Sanjeevani policy as a group cover
All the terms and conditions of the standard Arogya Sanjeevani policy have been retained except the premium, which is to be fixed by insurers. Health insurance companies are allowed to set their own minimum and maximum sum insured limits under the group policy. Note that the mandate of offering sum insured in multiples of Rs 50,000 is not applicable for the group product.
Arogya Sanjeevani policy covers hospitalisation treatment costs of COVID–19. The policy covers hospitalisation costs like room, boarding, and nursing at 2% of the sum insured. A maximum of Rs 5,000 can be used each day for such hospitalisation costs.
Also, in the Arogya Sanjeevani policy, pre-hospitalisation medical expenses, 30 days before the date of hospitalisation are admissible. And post-hospitalisation medical expenses for a period of 60 days from the date of discharge are admissible.
Corona Kavach policy as a group cover
IRDAI allowed insurers to offer Corona Kavach health insurance policy as a group health insurance product along with the individual one. The policy term can be of a minimum of three months to a maximum of 9.5 months. All the terms and conditions for the group policy will remain the same as applicable to the standard individual policy except the premium rate. The insurance providers will determine the price keeping in mind the cover that will be proposed to be offered to the company.
While life insurance providers can offer only benefit-based short-term health insurance policies, general and standalone health insurance providers can offer both indemnity-based and benefit-based short-term policies. The waiting period for short-term health insurance policies would not be more than 15 days. For regular health insurance plans, the waiting period is 30 days.
Among individual cover and group cover which one is better
While many employees can be covered under a group health insurance policy, buying an individual health insurance policy at an early age is better. Because a group policy won’t stay valid if the individual resigns or retires from the organisation. Also, if an individual exits the group plan and buys an individual health cover, the waiting period will start again. The individual and his/her family will be at risk during the period when he/she is under his/her new policy’s waiting period.
In case you rely on your group health insurance policy till retirement and plan on buying a cover after retirement, it would be very expensive and insurers may even deny you a policy on medical grounds. Again, all group insurance policies have coverage amount limitations that may get out of sync with rising healthcare costs. It is better to buy an individual health insurance policy with suitable coverage as per your needs any day.