Irdai to bring in standard vector-borne disease cover of up to Rs 2 lakh

The standard cover entails one base cover which will be offered on an indemnity basis and at most two optional covers which will be offered on a benefit basis.
After bringing in a standard health cover, covid cover, and term cover, now the insurance regulator has released an exposure draft for a standard vector borne disease health policy which will have a minimum sum assured of Rs 10,000 and a maximum of Rs 2 lakh.

This standard product will, essentially, provide coverage against vector borne diseases such as dengue, malaria, filaria, kala-azar, chikungunya, Japanese Encephalitis, and Zika virus. Policyholders can choose to protect themselves against any of the diseases or a combination of such vector borne diseases. And, insurers shall set the price for every covered disease separately and have been advised by the regulator to offer discounts as per the underwriting policy for opting various disease combinations.

The standard cover entails one base cover which will be offered on an indemnity basis and at most two optional covers which will be offered on a benefit basis. Also, the total amount payable in respect of base and optional covers shall not exceed 100 per cent of the sum insured during a policy period.

“The premium payable towards optional cover shall be specified separately so as to enable policyholders to choose and pay based on the need”, Irdai said.
Under the base cover, the hospitalization expenses incurred by the insured person for the treatment of vector borne diseases will be covered, where room, boarding and nursing expenses of upto 2 per cent of sum insured for the sum insured above Rs 20,000 and a fixed amount of Rs 500/day for sum insured up to Rs 20,000 will be provided. It will also cover costs related to medicine, PPE kits, gloves, and masks among other things.

Also, expenses on hospitalization for a minimum period of 24 hours will be admissible. For intensive care unit, cost upto 5 per cent of sum insured above Rs 20,000 and a fixed sum of Rs 1000/day for the sum insured up to Rs 20,000 will be covered. Also, ambulance charge of a maximum of Rs 2,000 will be covered.

When it comes to optional covers, under hospital cash benefit, 0.5 per cent of the sum insured shall be paid by the insurer each completed twenty-four hours of hospitalization due to positive diagnosis of covered vector borne diseases diagnosed during the cover period. And, the benefit shall be payable maximum up to 14 days during a policy period. While under the diagnosis cover, 2 per cent of the sum insured shall be paid by the insurer provided that insured is not hospitalized for the same illness within 15 days from diagnosis.

The regulator has said, this cover will be for a period of one year, with a waiting period of 15 days. But they have sought comments from stakeholders by November 27 on whether the product should be offered for a shorter term.


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