Corona-Kavach-Policy

KEY BENEFITS
The Policy provides cover for the treatment of Covid on an Individual or Family Floater basis. A separate Sum Insured for each Insured Person is provided under Individual basis while under Family Floater basis, the Sum Insured limit is shared by the whole family of the Insured as specified in the Policy Schedule and our total liability for the family cannot exceed the Sum Insured in a Policy period. The cover type basis shall be as specified in the Policy Schedule.

SALIENT FEATURES

ELIGIBILITY:
Any person aged between 18 years and 65 years can take this insurance for himself and his/her family consisting of Self, Spouse, dependent children, Parents and Parents-in-law, either on Individual Sum Insured basis or on floater basis. Beyond 65 years, only renewals are allowed.

Dependent children between the age of 1 day and 18 years shall be covered provided either or both parents are covered concurrently. Children above 18 years will continue to be covered along with parents till the age of 25 years. If the child is above 18 years of age and is financially independent, he or she shall be ineligible for coverage under the same policy in the subsequent renewals. However, a separate policy can be taken for him or her on expiry of the current policy for which continuity benefits will be provided.

SUM INSURED:
Various options are available as under:
Rs. 50000, 1 lac, 1.5 lacs, 2 lacs, 2.5 lacs, 3 lacs, 3.5 lacs, 4 lacs, 4.5 lacs, 5 Lacs.

TERM OF POLICY:
3.5 Months, 6.5 Months, 9.5 Months

COVERAGE
The covers listed below are in-built Policy benefits and shall be available to all Insured Persons in accordance with the procedures set out in this Policy.

Base Cover:
The covers listed below are in-built Policy benefits and shall be available to all Insured Persons in accordance with the procedures set out in this Policy.

1. Covid Hospitalization Cover:
The Company shall indemnify medical expenses incurred for Hospitalization of the Insured Person during the Policy period for the treatment of Covid on Positive diagnosis of Covid in a government authorized diagnostic centre including the expenses incurred on treatment of any comorbidity along with the treatment for Covid up to the Sum Insured specified in the policy schedule, for Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home.

Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses.
Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees whether paid directly to the treating doctor / surgeon or to the hospital
Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, ventilator charges, medicines and drugs, costs towards diagnostics, diagnostic imaging modalities, PPE Kit, gloves, mask and such similar other expenses.

Road Ambulance subject to a maximum of Rs.2000/- per hospitalization for the Ambulance services offered by a Hospital or by an Ambulance service provider, provided that the Ambulance is availed only in relation to Covid Hospitalization for which the Company has accepted a claim under section This also includes the cost of the transportation of the Insured Person from a Hospital to the another Hospital as prescribed by a Medical Practitioner.

2. Home Care Treatment Expenses:
Home Care Treatment means Treatment availed by the Insured Person at home for Covid on positive diagnosis of Covid in a Government authorized diagnostic Centre, which in normal course would require care and treatment at a hospital but is actually taken at home maximum up to 14 days per incident provided that:
The Medical practitioner advices the Insured person to undergo treatment at home.

There is a continuous active line of treatment with monitoring of the health status by a medical practitioner for each day through the duration of the home care treatment.

Daily monitoring chart including records of treatment administered duly signed by the treating doctor is maintained. Insured shall be permitted to avail the services as prescribed by the medical practitioner.
In this benefit, the following shall be covered if prescribed by the treating medical practitioner and is related to treatment of COVID,

Diagnostic tests undergone at home or at diagnostics centre Medicines prescribed in writing Consultation charges of the medical practitioner
Nursing charges related to medical staff Medical procedures limited to parenteral administration of medicines Cost of Pulse oximeter, Oxygen cylinder and Nebulizer

3. AYUSH Treatment:
The Company shall indemnify medical expenses incurred for inpatient care treatment for Covid on Positive diagnosis of COVID test in a government authorized diagnostic centre including the expenses incurred on treatment of any comorbidity along with the treatment for Covid under Ayurveda, Yoga and Naturopathy, Unani, Siddha and Homeopathy systems of medicines during the Policy Period up to the limit of sum insured as specified in the policy schedule in any AYUSH Hospital. Covered expenses shall be as specified under Covid Hospitalization Expenses (Section 4.1)

4. Pre Hospitalization:
The company shall indemnify pre-hospitalization/home care treatment medical expenses incurred, related to an admissible hospitalization/home care treatment, for a fixed period of 15 days prior to the date of admissible hospitalization/home care treatment covered under the policy.

5. Post Hospitalization:
The company shall indemnify post hospitalization//home care treatment medical expenses incurred, related to an admissible hospitalization//home care treatment, for a fixed period of 30 days from the date of discharge from the hospital, following an admissible hospitalization covered under the policy.

EXCLUSIONS

A.WAITING PERIOD EXCLUSIONS:
The Company shall not be liable to make any payment under the policy in connection with or in respect of following expenses till the expiry of waiting period mentioned below:

1. First Fifteen Days Waiting Period
Expenses related to the treatment of Covid within 15 days from the policy commencement date shall be excluded.

B.EXCLUSIONS
The company shall not be liable to make any payment under the policy, in respect of any expenses incurred in connection with or in respect of:

Investigation & Evaluation
Expenses related to any admission primarily for diagnostics and evaluation purposes. Any diagnostic expenses which are not related or not incidental to the current diagnosis and treatment

Rest Cure, rehabilitation and respite care
Expenses related to any admission primarily for enforced bed rest and not for receiving treatment.

This also includes:
Custodial care either at home or in a nursing facility for personal care such as help with activities of daily living such as bathing, dressing, moving around either by skilled nurses or assistant or non-skilled persons.
Any services for people who are terminally ill to address physical, social, emotional and spiritual needs.

Dietary supplements and substances that can be purchased without prescription, including but not limited to Vitamins, minerals and organic substances unless prescribed by a medical practitioner as part of hospitalization claim or Home care treatment.

Unproven Treatments:
Expenses related to any unproven treatment, services and supplies for or in connection with any treatment. Unproven treatments are treatments, procedures or supplies that lack significant medical documentation to support their effectiveness. However, treatment authorized by the government for the treatment of COVID shall be covered.

Any claim in relation to Covid where it has been diagnosed prior to Policy Start Date.

Any expenses incurred on Day Care treatment and OPD treatment

Diagnosis /Treatment outside the geographical limits of India

Testing done at a Diagnostic centre which is not authorized by the Government shall not be recognized under this Policy

All covers under this Policy shall cease if the Insured Person travels to any country placed under travel restriction by the Government of India.