Digit’s Coronavirus-specific insurance policy: Should you buy the cover?

Being a fixed-benefit policy, it will pay out claims even if the government has taken care of your expenses or you have filed a claim under your regular, indemnity-based health insurance policy. Claim will be paid out once the policyholder submits a certificate from a government medical officer to commence COVID-19 treatment or produces a positive virology report from the National Institute of Virology, Pune.

However, it will not be extended to individuals or their family members if they have travelled to certain countries, including China and Japan. It will also not be issued to individuals with symptoms such as cough (with or without sputum), cold or nasal block, fever with body pain or shortness of breath for up to six weeks preceding policy purchase. “Insurance works on the principle of utmost faith. The policyholders will have to give a self-declaration certifying that they do not have such symptoms,” says Chaturvedi.

The cover comes with a waiting period of 15 days – that is, if you contract the disease during this period, claims will not be payable. “The incubation period for the virus is 14 days. Thus, this waiting period clause will reduce the scope for disputes,” says Chaturvedi.

What works

Since Digit Health Care Plus is a fixed benefit policy, it will hand out the promised amount upon diagnosis of COVID-19 even if the government has already taken care of your treatment expenses. The policyholder can use the sum for recuperation post discharge as also to make good the loss of income during the treatment period. Documentation will be minimal and claim settlement relatively hassle-free. It reduces the scope for disputes around partial claim payment on account room rent sub-limits, pre-existing diseases, non-medical items and so on.

The negatives

There is a long list of restrictions, starting with the criterion for issuing the policy. If you or your immediate family members have travelled to China, Japan, Singapore, Thailand, Malaysia, Hong Kong, Macau, Italy, Iran, Bahrain, Kuwait and Taiwan since December 1, 2019, you will not be eligible. Health Care Plus, having been filed under IRDAI’s regulatory sandbox framework, is a limited-period product. Unlike regular health policies, which can ordinarily be renewed every year for lifetime, it will cease to exist once the entire sum insured is paid out or at the end of its one-year tenure. Moreover, its exclusivity (or USP) – cover for COVID-19 – is also its limitation. Policyholders can secure a policy with a larger and wider coverage if they can shell out extra sums.

Moneycontrol's take

If you are paranoid about COVID-19 and not covered by any form of health insurance – neither group not independent – might find this product useful. However, at present, world over, it’s the governments that are controlling the screening, quarantine and treatment processes. The expenses are borne by the authorities, which means that the disease is unlikely to burn a big hole in your pocket, should you be affected. This apart, you would be better off buying an adequate, comprehensive, regular health insurance cover instead. If you can afford a premium Rs 2,027 for a Rs 2-lakh policy that is valid only for a year, you might as well shell out another Rs 2,358 for double the cover that will also be renewable for life. Regular health policies will not only cover COVID-19, but also a wide range of ailments, barring the pre-existing ones. The IRDAI, on its part, has directed insurers to expeditiously process COVID-19-related claims in cases of hospitalisation, which is likely to make the process simpler for policyholders who have regular policies.