• CORONA VIRUS has hit India hard and has plunged the country into a lockdown for a long period. People are concerned about their health. The economic lockdown has also made people worry about salary cuts & losing their jobs.
• Existing health insurance indemnity policies of customers may not cover some expenses such as loss of income if they are not unable to attend office, business or shop etc.
• To help people overcome such economic loss, Royal Sundaram has come up with COVID SECURE, a Fixed Benefit Health Insurance plan to help them mitigate their loss of income and make their protection against CORONA Virus disease more comprehensive as it will act as their 'income protector plan'.
• The Product provides lump sum benefit to the person who is hospitalised or quarantined (including home quarantine) in India and diagnosed positive with Corona Virus.

Proposer can buy policy for self, spouse, son, daughter, father, mother, father-in-law, mother-in-law. For any other relationship, proposer can obtain cover for maximum 4 Insured Person(s). This will be subject to satisfying age and health criteria.

Proposer need not be mandatorily covered in the Policy.

Children: The minimum entry age under this policy is 21 years.

Adult: Minimum entry age is 21 years and maximum entry age is 65 years. There is no maximum renewable age.

The policy can only be purchased on an Individual basis.

Customer can buy the policy for one year. 'One Policy Year' shall mean a period of twelve (12) months from the date of issuance of the policy.

Customer has the option to choose from two types of Sum Insured:

Sum Insured is on Annual basis and will be payable on lump sum basis (fixed benefit).

A lump sum amount (Fixed benefit) will be paid if Insured Person shall contract and diagnosed positive for Corona Virus (this includes positive diagnosis after being quarantined), in the Policy year subject to following:

A. The insured person must have been diagnosed positive for Corona Virus in any Government designated laboratory in India, appointed for testing of Corona Virus disease.

B. The Insured Person has been either in-patient hospitalised or quarantined (including Home quarantine Institutional/Government quarantine) in India resulting from Corona Virus disease.

C. Insurance under this policy shall cease to exist for said Policy year upon payment of lump-sum amount.

D. The diagnostic test for Corona Virus should be as advised by World Health Organization or Indian Council of Medical Research (ICMR) and should be conducted in India from a diagnostic centreauthorised by Government of India/ ICMR Authorized Centre authorised to conduct Corona virus diagnosis.

E. The diagnostic test report of positive diagnosis should be after the completion of the 30 days initial waiting period

F. Benefit is only payable under reimbursement mode.

30 Days Initial Waiting Period:

Benefit under this policy related to Coronavirus shall be excluded for the first 30 days from the policy inception date.

EXCLUSIONS

The Company shall not be liable to make any payment under the policy if:

• If there is no In-patient Hospitalisation or quarantine (including Home quarantine /Institutional/Government quarantine) in India. Any quarantine which is not certified by the Competent Authority will not be considered.
• For Any Illness, sickness or disease other than Coronavirus.
• Any claim with respect to Coronavirus contracted or manifested or the onset of diseases or where the insured has tested positive for corona virus is prior to Commencement date of this policy or during the initial waiting period of 30 days.
• Coverage in respect of foreign nationals who are working in India. This exclusion shall however not be applicable in respect of OCI (Overseas Citizenship of India) cardholders working in India.
• Old form of Corona virus such as
  • a) Human coronavirus OC43 (HCoV-OC43), β-CoV
  • b) Human coronavirus HKU1 (HCoV-HKU1), β-CoV
  • c) Human coronavirus 229E (HCoV-229E), α-CoV
  • d) Human coronavirus NL63 (HCoV-NL63), α-CoV
  • e) Middle East respiratory syndrome-related coronavirus (MERS-CoV), β-CoV
  • f) Severe acute respiratory syndrome coronavirus (SARS-CoV), β-CoV

Cancellation

a. The Insured may cancel this Policy by giving 15 days written notice, and in such an event, the Company shall refund premium on short term rates for the unexpired Policy Period as per the rates detailed below.

Notwithstanding anything contained herein or otherwise, no refunds of premium shall be made in respect of Cancellation where, any claim has been admitted or has been lodged or any benefit has been availed by the Insured person under the Policy.

We shall apply a risk loading of 20% on the premium payable for Diabetes, if the person proposed to be insured is suffering from Diabetes and on continuous treatment for the same in the last 1 year and has an average HbA1C reading of 7.2 or above in the last 1 year, loading of 20% will be applicable. This is in line with Our board approved underwriting policy (based upon the declarations made in the proposal form and the health status of the persons proposed for insurance), which shall be mentioned specifically in the Schedule of Insurance Certificate. These loadings are applied from the inception of the initial Policy including subsequent Renewal(s) with Us or on the receipt of a request for increase in Sum Insured (for which the loading shall be applied on the increased Sum Insured).

Underwriting

COVID SECURE is a pre-underwritten product where no pre-policy medical check-up will be conducted. However, Customer must answer following medical questions mandatorily as a part of proposal form.

Any person answering as 'Yes' for Question numbers 1 / 3 and 4, will be denied cover. Persons with a HBA1C reading of 7.2 or above will be granted cover, with a premium loading of 20%.

Nationality:

This policy is available only for Indian citizens and OCI (Foreign citizen of Indian origin) card holders working in India and not for foreign nationals who are working in India or foreign tourists.

30 days waiting initial period is extremely critical in this product. Though it has been norm for all retail health product, especially in corona related claims it mitigates risk of anti-selection. As per observation across the world initially customers may be asymptomatic post having Corona virus infection and typically symptoms will show after 14 days (incubation period). Also patients who have been advised Corona disease treatment have been asked for 14 days' self-quarantine for post recovery, hence 30 days waiting period is bare minimum which follows.

For Claim to become payable, the date of diagnostic test report confirming the presence of Corona Virus should be after 30 days from 1st inception of the policy.

Discount:

This policy will be sold across multiple channels and there will be discount of 12.5% for policies sold through direct channel where there is no commission payable by Royal Sundaram General Insurance Co. Ltd.

Multiple Policies:

Multiple policies will not be accepted and hence to be avoided. Customer will be eligible for only one policy.