Applied for COVID 19 health insurance claim? REJECTED? THIS may be the reason

The COVID-19 has been giving sleepless nights to many. Amid the second wave of the pandemic, people have now already started worrying about the third wave. In terms of expenses, the sudden outbreak of the pandemic has also left people with limited options. People are figuring out options to battle the COVID war.  

Considering the same, the Insurance Regulatory and Development Authority of India (IRDAI) came up with two policies last year; Corona Kavach Policy and Corona Rakshak Policy. The Corona Kavach is a floater policy that covers the entire family, and the Corona Rakshak as the name suggests is an individual policy that only covers the individual holder.

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IRDAI has advised all the general and standalone health insurers to offer individual covid standard health policy called Corona Kavach Policy. Homecare treatment is covered under the Corona Kavach policy. As per the terms and conditions of the Corona Kavach policy, homecare treatment means undergoing the treatment for Covid-19 at home on the advice of a medical practitioner. Persons aged between 18 and 65 are eligible to opt for this policy. Dependent kid or kids shall be covered from day 1 up to 25 years of age. Insurers may also cover persons above 65 years of age as per the product design and underwriting policy of the company. 

However, these claims can be rejected on multiple grounds. So, before filing for a claim do check these details for unnecessary rejection later.   

Lapsed Policy: It is important for a policyholder to keep the policy active. This can be done only by paying a timely premium. If failed to pay the premiums on a regular basis, then a policy will lapse or will get inactive. If death happens in this case, then the life insurance company may deny the claim. 

Non-disclosure of pre-existing diseases: The policyholder has a pre-existing illness such as Cancer, Diabetes, or any other major illness, and he has not disclosed while buying the policy, then insurers may disapprove to honour the claim. 

So, the documents that you submit should be genuine, then only you are entitled to a quick claim. However, individuals can raise a complaint, if he thinks his policy claim was rejected on unclear grounds.