Finance

Health Insurance: Insure against vector-borne diseases

Some insurers offer coverage for day care treatment, coverage of medical costs incurred up to 30 days during pre and post hospitalisation period and even automatic recharge of sum insured if it is exhausted due to multiple claims.

During the monsoon it is important to take stock of the health risks you face from various vector-borne diseases which are very common across the country. Such diseases can become fatal if timely care is not taken. If an individual does not have a comprehensive health insurance policy, then he should ideally buy a specific vector-care insurance for himself and his family which can take care of any financial setbacks that might occur due to medical treatment for vector-borne diseases such as dengue, malaria, etc.

For instance, the treatment cost for dengue can range between Rs 30,000 to Rs 2 lakh. Also, if one has a comprehensive health insurance cover with a low sum insured, then he can buy the specific vector policy as a supplementary cover, especially if he lives in an area where the spread of such diseases is frequent.

Apart from specific vector-borne covers, popularly known as dengue policies that general and health insurers offer, the insurance regulator has asked all general insurance companies to launch a standard vector-borne disease health policy to cover dengue fever, malaria, filaria, kala-azar, chikungunya, Japanese encephalitis and zika virus.

Specific vector-care insurance
In vector care policies, the insurers provide a lump sum benefit in case the insured is diagnosed and hospitalised for a minimum period of 24 hours due to diseases caused by vectors. To buy the cover, insurers do not ask for any pre-insurance medical examination test, irrespective of the sum insured and age of the insured. The sum assured can range between Rs 10,000 to Rs 1 lakh and is offered on both individual and floater sum insured. Insurers pay a lump-sum which is 100% of the sum insured if the policyholder gets hospitalised due to any specific vector-borne disease. There will be no loading on premium for adverse claims experience.

The minimum policy term is one year for all insurers and some insurers offer the policy for a period of three years. For long-term policies, the insurer offers discounts of up to 10% on the premium. Typically, the premium for a policy cover of Rs 10,000 sum insured would be Rs 150-250 per person per year depending on the inclusion and exclusions done by the insurance company. Similarly, for a sum insured of Rs 1 lakh, the premium would range between Rs 1,200 to Rs 1,500 per person per year. The maximum entry age is usually 65 years and can be renewed for life. These policies have an initial waiting period of 15 days from the date of commencement of risk.

Some insurers offer coverage for day care treatment, coverage of medical costs incurred up to 30 days during pre and post hospitalisation period and even automatic recharge of sum insured if it is exhausted due to multiple claims.

Standard vector-borne disease policy
The standard vector-borne disease cover called Mashak Rakshak is a fixed benefit health insurance policy, which pays a lump sum benefit equal to 100% of the sum insured when a claim is made for requiring hospitalisation for a minimum continuous period of 72 hours. The standard policy is offered both on individual and floater sum insured basis, where the minimum is Rs 10,000 and maximum is Rs 2 lakh. The tenure of the policy is fixed for a year and can be renewed every year.

The policy has diagnosis cover where 2% of the sum insured is paid on positive diagnosis of covered vector borne disease through laboratory examination and confirmed by a medical practitioner. A policyholder is paid for diagnosis cover for each disease only once in the policy year. The pricing is fixed by the insurer and no deductibles are permitted in this product. In spite of the Insurance Regulatory and Development Authority of India mandating all general and health insurance companies to come out with this use-and-file product by April 1, insurers have been slow in launching them.

What should you do?
While a comprehensive health insurance cover with adequate sum insured combined with a cost-effective top-up policy is ideal to cover almost every type of medical contingency one might face, a disease-specific cover like vector-borne policy can be helpful in case one does not have a comprehensive cover with an adequate sum insured.

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