The Insurance Regulatory and Development Authority of India (IRDAI) on April 1 launched the Arogya Sanjeevani -- a standard health insurance policy for individuals and families. The regulator mandated all insurance companies to offer this policy which provides coverage of up to Rs 5 lakh
for basic hospitalisation-related expenses.
for basic hospitalisation-related expenses.
The IRDAI website said, "In the context of outbreak of COVID 19 pandemic, it is clarified to the Public, that indemnity based health insurance products that cover the treatment costs of hospitalization offered by all general and health insurance companies cover the costs of hospitalization treatment on account of COVID -19. All insurers have been advised by the Authority vide Circular dated 30th March, 2020 insurers to expedite settlement of COVID 19 related claims."
The authority had issued guidelines on Standard Health Insurance Policy called Arogya Sanjeevani and had issued clearance to 29 General and Health Insurance companies to market this product. Interested people can avail of this Standard Health Insurance policy by approaching the listed insurance companies.
Note that while the coverage and terms & conditions of this policy are universal for all insurance providers, the buyer has the choice to purchase this policy from any insurer. However, the premium rates and customer service can vary from one insurance provider to another.
Features of Arogya Sanjeevani health policy:
It offers a standardised product that covers basic hospitalisation needs of customers.
This policy comes with minimum sum insured of Rs 1 lakh and maximum of Rs 5 lakh.
These are available for both individual and family.
The minimum and maximum entry age are 18 and 65 years. For children under 'Family Floater' policies, the entry age is 3 months and exit is 25 years.
This policy is annually renewable with a grace period of 30 days.
A co-payment of 5 per cent is applicable across all ages meaning the policyholder is required to pay 5 per cent of the bill amount compulsorily.
No add-ons and optional covers are available in Arogya Sanjeevani Policy.
What is covered in this policy:
All pre and post hospitalization expenses, that could occur due to an illness or accident. Treatment and hospitalization for the Covid-19 too.
Alternative treatments done as an inpatient ineligible hospital.
Room rent covered up to 2% of the SI maximum up to Rs 5,000 per day.
ICU/ICCU charges covered up to 5% of the SI maximum up to Rs 10,000 per day.
Ambulance charges with a maximum cap of Rs 2,000 per hospitalization included.
Plastic surgery or dental treatments necessitated owing to an injury or a disease.
For expenses incurred towards the treatment of cataract for each eye, policyholders can avail coverage of up to Rs 40,000 or 25% of the total sum insured, whichever is lower.
Modern treatments, including Balloon Sinuplasty, Immunotherapy and Stem Cell Therapy, amongst many other treatments covered to up to 50% of the total sum insured.
According to most financial experts, this insurance policy is a good entry-level product. However, there are some experts who believe that the insurance coverage of Rs 5 lakh is not sufficient for covering a family of four. One of the benefits of this policy is that it is relatively cheaper.
