Know How to File Claim for Coronavirus

As India’s 1.3 billion people remain under ‘lockdown’ to combat the spread of the coronavirus pandemic, the numbers tell some other story. The total number of known coronavirus cases in the country has crossed the 208K -mark with the death toll rising to 5815 due to COVID-19. The number of coronavirus cases crossed 2,00,000- mark on Wednesday, nearly half of this number is active cases and around 100303 have been cured, as per Union Ministry of health. On a whole, more than 6.19M people across 195 countries are infected with COVID-19 of which 300K have recovered while more than 376K have lost their lives.

As health researchers have warned that the number of people infected with coronavirus in India may increase, it’s important that apart from taking precautionary measures like staying at home and washing hands as frequently as possible, people must even think about insuring themselves with an adequate health insurance policy to stay secured against unexpected financial expenses. Buying a health insurance cover to protect you and your family from unseen health care expenses is quite a responsible step taken in the right direction. Health insurance cover offers adequate coverage for all possible medical expenses incurred by the policyholder during the policy tenure. Depending on the type of your health insurance policy, you can claim for different medical expenses that can include hospitalisation costs, day-care procedures, surgeries, pre, and post-hospitalisation costs, etc.

For treatment of COVID-19, the hospital/clinic will first test you for coronavirus whether you are corona positive or not. The private labs have been asked to cap the test at Rs 4,500. The test will only be allowed at NABL-accredited private laboratories and the test includes Rs 1500 for a screening test for suspect cases and an additional Rs 3,000 as confirmation test charges. However, people who might test positive for COVID-19 need not worry about the test charges as the test charges fall under pre-hospitalisation expenses and all the pre-hospitalisation expenses are covered. In all cases, charges incurred by an individual 30 days prior to his or her admission to any hospital fall within the ambit of pre-hospitalization expenses, and these are covered under health insurance policy.

However, while making a claim for pre-hospitalisation expenses, it is important that one must keep in mind the exclusions that fall under a health insurance policy. In order to make a claim for pre-hospitalisation expenses, it is important that the person for whom the bills are submitted is hospitalised within 30-days of the expenses incurred. If hospitalisation does not occur within 30-days, the claim is not accepted and the policyholder has to himself pay for the expenses incurred. Also, the insurer only pays for the relevant expenses like tests and x-rays that are related to the illness for which hospitalisation is done.

The procedure to file a claim in case you get hospitalised for treatment of coronavirus infection is the same as any other claim. All that a policyholder needs to do is make a health insurance claim either through cashless or reimbursement mode. If you test for coronavirus, you may choose to take treatment as your choice of hospital and if that hospital falls under your health insurance provider’s network, you can avail cashless hospitalisation facility however in case your choice of hospital is not listed with the insurer, you still may take treatment at the hospital however you would be required to pay the bills by yourself. Though the bills will be reimbursed once you file a claim with the insurer. In both the claim processes, it is important for you to inform your insurer about your hospitalisation and register a claim request. This can be done at the TPA desk available at each hospital.

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