Vector-borne Disease Coverage by Health Insurance

The Covid-19 pandemic outbreak has opened the insufficiencies in several sectors of our systems and our healthcare system is no exception to this. It has been compelled to bring revision to the existing system to handle such unprecedented medical emergencies on such a wide scale, dealing with vector-borne diseases. IRDAI has revised the rules and regulations that brought the emergence of several health insurance plans offering various health insurance benefits for vector-borne diseases. 

As per the revised norms of IRDAI, there has been a development in the standard framework for standard vector-borne disease health insurance and has essentially encouraged the insurance companies to begin offering the product to the customers from April 2021 onwards. 

An Overview of Vector-borne Diseases

As per the definition offered by WHO vector-borne diseases are those human ailments that are caused by parasites, bacteria, and viruses that have been transmitted by a potential vector. In this case, the vector can be an insect that is fed by blood, like fleas, triatomine bugs, mosquitos, ticks, sandflies, etc. As per the IRDAI norms in the Indian context, some of the most popular vector-borne diseases are chikungunya, dengue, malaria, Japanese encephalitis, filaria, nipah virus, and zika virus. 

Due to the subtropical and tropical climate clubbed with increasing globalisation and urbanisation, these ailments have affected our Indian society gravely. Moreover, the existing weak healthcare system adds up to the suffering, making people all the more vulnerable to such ailments. 

Dengue and malaria are particularly vicious vector-borne diseases in this country, causing havoc among thousands each year, even leading to fatality, due to lack of proper access to the standard healthcare system. India ranks fourth in the total number of yearly malaria cases in the world. 

The Necessity to Purchase Vector-borne Disease Insurance Cover Despite Possessing a Health Insurance Plan

Due to the skyrocketing medical treatment costs, it has become mandatory to invest in a proper health insurance plan. There are various types of health insurance plans to choose from. There are senior citizens health insurance plans, critical illness health insurance plans, personal accident insurance, etc. However, the daily hike in medical inflation has made it almost impossible to possess enough health plans for yourself and your family. You need to clarify all the details very carefully to purchase a plan suiting your needs. Because of such high inflation, it is prudent to purchase a separate cover for vector-borne diseases, apart from the regular health plan. Some of the major benefits of buying vector-borne health insurance cover are:

• Proper Coverage Against Vector-borne Diseases: By purchasing a vector-borne health insurance plan, you can conveniently supplement the necessary coverage as offered by your existing health plan. In case, the policyholder is ever diagnosed with a vector-borne disease, he/she becomes eligible to access proper financial assistance. 
• Maintaining Financial Stability: By maintaining a separate health insurance policy for vector-borne diseases, you can efficiently manage your finances while accessing expensive medical expenses for treatment. Losing all your savings and getting indebted is never a viable option, especially in the long run. 

Some Basic Details of Health Plans for Vector-borne Diseases

The IRDAI has instructed all the general and health insurance providers in the country to offer the already proposed standard vector-borne disease health plan for positive contribution to the sector, offering proper validity of the product. Some of the major components of the plan are:

• Lump-sum Benefit: This is one of the major perks of the plan. The beneficiary is liable to receive a lump sum equivalent to 100% of the total sum insured. It excludes the diagnosis cover. However, this money won’t be paid if the policyholder has received a positive diagnosis report for the vector-borne ailments covered; and/or at least 72 hours of hospitalisation is prescribed by the doctor. 
• Diseases Covered: As per the recommendation of IRDAI, the diseases covered include malaria, dengue, kala-azar, Japanese encephalitis, filarial, and zika virus. However, the particular vector-borne ailments covered by the concerned insurer are subjected to their individual policies. 
• Diagnosis Cover: This is only payable only if you are tested positive without the need for getting hospitalized for a long span. This allows 2% of the entire insured amount and the concerned beneficiary is only eligible to avail of this once yearly during the plan tenure. 
• Diagnosis Requirement: The eligibility for all these payments get justified based on certain rules, one of which is that the entire treatment course and diagnosis should be mandatorily done in licenced allopathic centres by authorised allopathic professionals.
• Policy Duration: Similar to other standard health insurance plans, a vector-borne disease plan is also available for a stipulated tenure. The minimum span is 1 year. You can ensure this health insurance renewal subject to your eligibility as per the norms of the concerned insurance company. 
• Sum Insured: The minimum coverage limit for vector-borne diseases is set at INR 10,000, while the maximum limit is INR 2 lakhs. As per the IRDAI norms, the decided sum must always be in multiples of INR 10,000.
• Coverage: This is a single-premium plan. This implies that the policyholder becomes eligible for the relevant compensation on the respective diagnosis of relevant vector-borne diseases, provided it follows the norms of the concerned plan. However, in case you are diagnosed with any such ailment before the completion of 15 days, then the concerned insurance provider won’t provide you with any sort of compensation.
• Entry Age: The minimum age limit for availing of the benefits of vector-borne disease coverage is 18 years, while the maximum limit is 65 years. Dependent children receive coverage from the first day of their birth till 25 years. 
• Policy Termination: After 100% of the insured sum is paid, the plan stands terminated for the respective policy year. In case the plan is issued for any family with a respective sum insured for every individual member, then the plan holds true for the other members insured. 

Common Exclusions of Vector-borne Disease Health Plan

Some of the common exclusions of the vector-borne disease health plan are:

• If health insurance claims are filed for the treatment of several ailments other than for particularly vector-borne diseases that remain covered under the plan.
• Treatment or diagnosis of specified diseases outside the geographical boundaries of the country.
• Any diagnosis or test that is not approved or recognized by respective authorities.
• Any expenses incurred due to unproven treatments which lack substantial documentation.

Conclusion

The above discussion shows enough reasons for purchasing a separate health plan for vector-borne diseases. These days it is very easy to purchase health insurance plans using the digital platform. You can easily compare health insurance plans and grab the best deal, suiting your needs.

Read more -

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