Insurance to cover hospitalisation due to adverse COVID-19 vaccine reaction

The regulator said that the coverage is subject to specific terms and conditions of the insurance policy.
COVID-19 vaccination
COVID-19 vaccination
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Insurance regulator, IRDAI, on Thursday said that the hospitalisation of a policyholder due to any adverse reaction after getting vaccinated against COVID-19 will be covered under health insurance policies, subject to conditions.

In a release, the Insurance Regulatory and Development Authority of India (IRDAI) mentioned reports that raised doubts about whether any adverse reactions to COVID vaccination that require hospitalisation will be covered by the health insurance policies.

"It is clarified that in the unlikely event of hospitalisation following an adverse reaction to COVID-19 vaccination, hospitalisation is covered under the health insurance policies subject to the specific terms and conditions of the policy," the regulator said.

Due to the pandemic, the insurance regulator had told companies to roll out a standard insurance policy so that people do not have to compare policies of different companies and there would be easy access to insurance for everyone. The policy called Arogya Sanjeevani, covers hospitalisation, pre and post-hospitalisation, AYUSH treatment, and cataract treatment. It takes care of basic requirements.

On Thursday, the regulator modified the guidelines and lowered the minimum limit of coverage to Rs 50,000 and raised the maximum limit to Rs 10 lakh. 

As per IRDAI’s guidelines last July, guidelines for the Arogya Sanjeevani Policy had directed insurers to offer options ranging from a minimum of Rs 1 lakh to maximum of Rs 5 lakh.

"In order to enhance the coverage available under Arogya Sanjeevani Policy, in partial modification of the extant guidelines, insurers shall mandatorily offer the sum insured between Rs 50,000 to Rs 10,00,000 under the standard product Arogya Sanjeevani w.e.f 1st May, 2021 or earlier," IRDAI said in a circular.

The modified guidelines, however, do not apply to the two specialised government-owned general insurers, ECGC and AIC, IRDAI said. Agricultural Insurance Company of India Limited (AIC) is for the farm sector. ECGC provides export credit insurance support to Indian exporters and is controlled by the Ministry of Commerce.

Insurers may launch the modified version of the Arogya Sanjeevani Policy after filing the same on a certification basis.

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