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How Coronavirus Affects the Health Insurance of Employees

Fear is an integral part of our life. It could be the fear of an eight-legged creature, the fear of the dark, or merely the horrifying nightmares that a lot of you witnessed during the Financial Crisis of 2008. But, with time we prepare ourselves for these problems, as we know what it’s like to witness them. Unluckily, this time it was all different. The Coronavirus pandemic brought a new scare into the world, which we do not know how to fight against (yet). This has led us to come off the defensive; we are scared to take risks because there is just too much uncertainty all around. 

But more than business; this time the uncertainty is about one’s health. We do not know whether we would be healthy or wealthy enough to fight this horrible virus. Though we may not be entirely sure about our health, we still can make provisions for wealth. This is right where the health insurance sector comes into play. 

Impact of Coronavirus on the Health Insurance Sector

It does not take a PhD to answer that which insurance was most impacted due to COVID – 19. The Health Crisis had to bring disruptions to the Health Insurance Sector. Mind you; it’s not all that bad as you will know shortly. 

1.        Customers are growing: The Coronavirus free advertisement campaign means that you and I are now suddenly scared that we are not immune to health problems. This has led to a sudden realization in us, that perhaps covering for our health costs isn’t the worst option after all. Indeed, we see that many people think like us as the medical coverage related inquiries to Medical insurance companies increased by 30-40 per cent after the Coronavirus scare. 

2.        Telecare: Further, our hesitation in going outside has resulted in us taking the telephone route to treatment. This is good news for the insurance companies as the cost to telecare is lesser than in-person treatment, and if this becomes the norm, then they are perhaps in for a bumper package. 

3.        Uncertainty: All is not well though as the companies as instructed by IRDAI have to put COVID–19 treatment under their coverage. This brings a lot of problems to the insurance providers, think of you giving money for something you don’t know everything about. Furthermore, this also means that all our existing plans are under-priced as they were made in the absence of COVID–19. Lastly, even if they are priced now, would you be sure that you would be given a fair price when companies are themselves not very sure about the same. 

Coronavirus Impact on Employees Health Insurance 

While we can debate about whether the impact of COVID–19 is good or bad for the economy, I think we can all agree in unison that it hasn’t been the best for employment. With unemployment rates at unimaginable levels, employers are finding it tough to fund their workers. But, surprisingly, even workers are hesitant to come, and why wouldn’t they. Just like you and me, they need ample assurance about their personal health before coming to the work place again. The IRDAI has just realized that and made its moves. 

The circular dated 15th April 2020 clearly states that some things were to be mandatory before work actually started. This, among other things, included proper social distancing norms and compulsory medical insurance by employers of employees, perhaps something that the employees wanted. It wasn’t a one-sided thought as the government also advised insurers to make such plans at more affordable rates. Again, the burden did not fall off them as only workers with monthly salary of up to Rs.20,000 were covered by The Employee State Insurance (ESI). 

This suddenly means that we have a lot more coverage. If you are below a salary of Rs. 21000 a month, the government is covering you; otherwise, the employer steps up. Let us know more about them. 

Employee State Insurance Benefits (ESI)

Mind you; the ESI is not new. This had been in place since 1948 to help the organized sector employees. So, why is it in the limelight right now? The answer is because it recently underwent three amendments, or shall I say relief measures for the employees under its ambit. 

1.        Private covered too: It was recently announced that the employees would be allowed to purchase medicines from private chemists and they would be reimbursed later. This was a significant relief, as according to me more centers for purchase are better than the selected few. 

2.        Seek Medical Treatment without Referral: As the name suggests, registered members were finally allowed the liberty to get themselves checked from partner hospitals without a referral letter. This was a significant change but did not have a drastic impact as the beneficiaries weren’t aware of the difference in the first place. 

3.        Pay Premiums Later: Allowing the already struggling employees to pay the premiums later was much needed according to me. The extension of payment of premiums of February and March were allowed to be paid till May without any interest rates. The ESI also did a major change by bringing COVID-19 under the ambit of this coverage. At least now we are sure that some employees are definitely well covered. 

Group Insurance Plans for Employees or Contractual Workers

If the IRDAI notification isn’t conclusive to tell employers to extend Health Insurance plans I don’t know what is. As every crisis presents an opportunity for innovation, this was the perfect time for the insurance companies to step up their game and bring a new product. Well, they didn’t disappoint us and we have Group Health Insurance plans for employees. As claimed Group Insurance companies may be the perfect balance between both employee and employer needs. Obviously, I am talking about the ones who aren’t covered under the ESI health insurance plan. 

To make it interesting, this COVID – 19 special plans have somewhat special features that all the other group insurance plans do not have. Let us lookout for them. 

1.        Individual Cover – Unlike group health insurance, every particular employee has his/her individual cover. This means that the other people can’t claim on your share of the coverage and you are covered individually up to the total sum insured amount. 

2.        Wider Coverage – Unlike, most group health insurance plans, this one isn’t just meant for the permanent employees for the business. Even the contractual and casual laborers would be included in these plans, which is what makes it different.

3.        Optional Floater Cover – Few insurance companies also offer floater cover to the insured under this scheme. However, it has a caveat that it is only applicable if the employer chooses to opt for this at the time when he/she is purchasing this policy. 

Well, these exciting features not only ensure that all the rules by IRDAI are followed but also provide two necessary things. It guarantees greater safety of the employees at the workplace and definitely brings about greater employee loyalty. If you can show them that you can think of their interests, they will surely respond positively.

FAQs: Coronavirus and Health Insurance

Is maternity benefit available under Coronavirus insurance for labor?

Generally, the insurance companies do not provide for maternity benefit under the Coronavirus scheme for contractual workers, but there are some special schemes by some companies which do cover maternity benefit as well. These include the likes of Reliance Insurance, which offers coverage only if more than 51 employees are insured by the policy.

What are the common coverage benefits under my health insurance?

This does not have a clear answer as health insurance benefits differ from policy to policy. However, there are some basic benefits. These include cover for inpatient hospitalization, daycare procedures, pre & post hospitalization, organ donor expenses, domiciliary hospitalization, OPD expenses, and more.

I have been recently diagnosed with a medical condition. Will I be allowed health insurance?

If you have already been diagnosed with a medical condition, it will be considered as a pre-existing disease. In this case, generally, the insurance companies will not deny you coverage for that specific disease, but you may have to wait for a specific period (waiting period) until allowed coverage. Based on your insurer, you may also be required to pay a higher premium or risk facing policy denial.

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