covid 19 & Health Insurance claims

Important Details You Need to Know About COVID-19 and Related Claims

2nd April 2020 8min read 10657 views

The coronavirus pandemic has shaken the world to its very core. Over 800,000 people have been affected around the world with several losing their lives to the disease. Governments across the globe are doing their best to test possible carriers and isolate them. If you think you may have the virus, or turn out to be positive and need to be hospitalised, you don’t have to worry. Your health policy will help take care of you. In order to ensure that you stay safe and get the best level of care possible, here’s a look at some important details that you need to keep in mind:

Hygiene – Your First Line of Defence

The easiest way for you to stay healthy and safe is by following a few practices that are recommended by the World Health Organisation (WHO):

1. Wash Your Hands – Wash your hands with a combination of soap and water for at least 20 seconds at a time several times a day. This will help get rid of any strands of the virus that you may have come in contact with.

2. Avoid Touching Your Face – The virus can easily enter your body through your mouth, nose and your eyes. So it’s crucial that you don’t touch your face unless you’ve just washed your hands.

3. Maintain Social Distance – As far as possible, it’s best to stay at home and not come in contact with others. But, if you absolutely have to leave your home, remember to maintain at least 1 metre of distance between you and the people around you.

Warning Signs You Should Check For

If you think you do have the virus, you need to check for these initial symptoms:

  • Fever
  • Dry Cough
  • Breathing Difficulties

Getting the Right Help

The Government of India is doing its best to ensure that every citizen has access to accurate information regarding the pandemic. You can simply send a WhatsApp to the number +91 90131 51515 to reach the MyGov Coronavirus Helpdesk. They will share the most accurate information about the virus with you so that you can prepare yourself accordingly. If you require any medical assistance, you can:

  • Call: +91 11 23978046
  • Call the Toll-Free Number: 1075
  • Email:

If you’d like to get in touch with your state or union territory’s direct helpdesk, click here to find the helpline number or visit the Ministry of Health’s official website for more details.

Most importantly, India’s general insurance sector has taken steps to help all policyholders who may have contracted the virus or may be grappling to deal with the lockdowns and other rules and regulations in place to help tackle the spread of the coronavirus. You can check out the General Insurance Council’s official website to learn more about the impact the coronavirus has on your various general insurance policies.

What Will I Be Covered For?

If you are diagnosed with coronavirus, here’s a look at everything your health policy will cover you for:

  • If you need to be quarantined, we will treat this as part of the hospitalisation benefit you are eligible for under our policy. Everything from normal hospital treatments to treatment in the ICU is covered under our policy.
  • We will also provide hospital cash benefits for up to 7 days of your hospital stay for any out-of-pocket expenses as per your policy’s terms and conditions.
  • If you’re unable to make it to a hospital near you, we will help take care of the treatment you get at home with our domiciliary hospitalisation benefit. If you’ve opted for alternative treatment, we’ll look after that under the AYUSH benefit.
  • You can avail cashless treatments at a network hospital near you as long as you remember to carry your TPA card. If there are no network hospitals nearby, don’t worry. We’ll reimburse you, as per your policy’s conditions, for treatment at non-network hospitals.

How Do I Avail of Cashless Claims?

With Edelweiss, claiming is simple and stress-free. All you have to do is follow these easy steps:

  • Call us on the toll-free number 1 800 12000 or visit the TPA department of the hospital
  • If you prefer, you can also write to us on
  • Well will pay upto 100% of your claim amount against quarantine and detection charges

Important Dos and Don’ts

When you’re making a claim, here are some important dos and don’ts to keep in mind:

Do Keep Your Documents Safe
This is especially important if you are looking for a reimbursement claim instead of a cashless claim. Keep all your hospital bills and medicals files safely. You will need to submit them with your claim form.

Do Intimate Us
Remember to file your claim within the stipulated time limit to avoid possibility of rejections.

Do Remember Your Room Rent Limit
Your policy will have a stipulated amount that we will pay for your daily room rent. You will have to select your room at the medical facility accordingly to avoid out-of-pocket expenses.

Don’t Forget About Pre- and Post- Hospitalisation
Your policy documents will outline the pre- and post-hospitalisation limits for which claims can be made. Make sure you check your policy carefully before lodging your claim.

Don’t Forget About Co-Pay
When you purchased your policy, you may have opted for co-pay. This is a small percentage of t he total claim amount that you have agreed to pay for every claim. It’s vital that you make this payment at the time of discharge.

Some Important Answers

If you aren’t sure about a few things, here are some important questions that you may need the answers for:

1. Is there a waiting period applicable for hospitalisation expenses related to the coronavirus?
A: There is a waiting period of 15 days applicable under Group Health & Health Insurance (effective from 01.02.2021 till the period Government & /or WHO declare it as ableed)

2. Will expenses incurred during the quarantine period be covered by the policy?
A: If your quarantine has taken place in a medical facility or another facility set up by the government for the sole purpose of keeping people in quarantine, then yes, we will cover expenses incurred during that period as well.

3. I have recently travelled to Italy. Will my claim be covered?
A: Absolutely. Travelled from any part of the world and being tested positive further prescribed hospitalization is not an exclusion under the Edelweiss Health Insurance Policy. Any hospitalization expenses incurred in India is covered under the policy

4. I have come in contact with somebody who has returned from overseas travel. Will my claim be covered?
A: Yes, if you have been in contact with the affected or carrying symptoms.

5. Will an intimation e-mail suffice for cashless treatments?
A: If you’ve opted for cashless treatments, you are not required to send us an email. You can simply visit the TPA desk at the hospital and show them a copy of your policy or your TPA card to avail cashless treatment.

6. How do I find cashless hospitals in my area?
A: We’ve got a great network of hospitals, so you’ll always be close to a cashless facility. To see our complete list of network hospitals,
simply click here.

7. What is a TPA?

A: A TPA or third-party administrator is an organisation that helps us process your

insurance claims


8. When and where should I submit the original bills after getting discharged in case of reimbursement?
A: You will need to submit the claim form and all the original bills to the TPA within 7 days of your discharge for a reimbursement claim.

Getting in Touch with Us

If you are our customer, an agent or an intermediary, click here to access handy list of helpline numbers to reach out to us

Dealing with the coronavirus pandemic may not be easy, but it is possible to get the treatment you need with our health policy. Don’t forget to take precautions and stay as safe as possible.

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