Do I Really Need A Medical Insurance Plan For Vector-Borne Diseases?

Today, we live in a world where we are more cognizant of our mortality than ever. The COVID-19 pandemic has changed the way the world functions fundamentally. The inadequacy of our existing health care architecture is perhaps the starkest. With awareness of these problems comes the efforts to start amending our infrastructure to be more robust. One of the most glaring deficiencies brought to light during this time, as we are made aware of the problems in our healthcare system, is the lack of insurance or monetary compensation for those who suffer due to vector-borne diseases. In fact, to combat this deficiency in our healthcare system, the Insurance Regulatory and Development Authority of India (IRDAI) presented a new set of guidelines in February of 2021.

These guidelines have provided a framework for a Standard Vector-Borne Disease Health Policy, which healthcare insurance companies should provide as a part of their product list. The goal of this policy is to ensure standardized coverage for vector-borne diseases. Additionally, the IRDAI hopes to encourage insurers to provide their customers with the requisite services. As the IRDAI has encouraged insurance companies to start offering this product by the 1st of April 2021, it is just in time for the monsoon season - the season where vector-borne diseases are the most common. At this time, COVID-19 still poses a considerable risk for many people. Additional assurance for other health care matters is not remiss.

But what is vector-borne disease? And why is insurance for this necessary for you? Let us have a look at the various important aspects of this Standard Vector-Borne Disease Health Policy.

Vector-Borne Diseases - an overview

The definition given by the World Health Organization (WHO) is straightforward. A vector-borne disease is any human illness (caused by a virus, bacteria, or parasite) that has been transmitted by a vector. The vector, in this case, is an insect that feeds on blood, for example, mosquitoes, fleas, ticks, etcetera.

That last sentence would have tipped off exactly what diseases fall under the vector-borne disease category. However, the list is longer than you probably think. The most common vector-borne diseases in India, and the ones that the IRDAI policy is aimed towards are - dengue fever, malaria, filaria (also known as lymphatic filariasis), kala-azar, chikungunya, Japanese encephalitis, and the zika virus.

These diseases disproportionately affect India because of the tropical and sub-tropical climate, along with increasing urbanization and globalization. The weak health care infrastructure does not make for a strong response against these diseases and leaves many people vulnerable to them.

Malaria and Dengue are particularly infectious and deadly vector-borne diseases in India. Overall, thousands of people suffer every year in India because of these diseases, and sometimes the complications can lead to the unfortunate death of the patient due to lack of access to quality medical treatment.

What benefits can you get from insuring against vector-borne diseases?

First! As the monsoon season approaches, vector-borne diseases will become more and more prevalent. Dengue and malaria particularly will become more and more common as they are still unfortunately prevalent in various regions of India, and diagnosis and treatment can both be lengthy and expensive. As much as we are confident that it will not be us who will get sick, being smart and planning for the future is always wise. General and healthcare insurance companies will have various options to help you to find the premiums and plans that work the best for you. Predicting the future is not possible, but taking measures to protect you and your family against common problems is the smart thing to do.

After all, prevention is the best cure - especially for your finances. And access to quality health care is costly, and the last thing a person wants to do when taking care of their health is compromised on the treatment quality. Having even the most basic health insurance can help take off the financial burden of good health care and help you give yourself and your families the best care possible. With the help of this Standard Vector-Borne Disease Health Policy, you can enjoy comprehensive financial support against expenses incurred for the treatment of vector-borne diseases at any of the approved hospitals or healthcare centres.

The details of health insurance for vector-borne diseases

The Insurance Regulatory and Development Authority of India has urged all general and health insurers in the country to offer the proposed Standard Vector-Borne Disease Health Policy. The guidelines they have provided for such a will contribute positively in a few ways. First, it sets a standard and allows Indian citizens to recognize a good offer from a bad one. Secondly, it gives insurers the ability to provide validity to their product.

The guidelines provided by the IRDAI include some key components regarding the Standard Vector-Borne Disease Health Policy. Here are some of the most important inclusions of the Standard Vector-Borne Disease Health Policy: -

• Lump-Sum Benefit: The lump-sum benefit is a big perk of this policy. The lump sum that the beneficiary can receive must be equal to 100% of the sum insured. This money excludes the money paid under the next component, which is the Diagnosis Cover. The money will only be payable after the policyholder has:
  1. 1. Received a positive diagnosis for the covered vector-borne diseases
     2. A 72-hour hospital stay has been prescribed by the doctor

• Diseases covered: For clarification, The IRDAI has recommended that the following vector-borne diseases be covered - dengue fever, malaria, filaria, kala-azar, chikungunya, Japanese encephalitis, and the zika virus. However, the vector-borne diseases covered by the insurer are subject to their own policies.
• Diagnosis cover: The aforementioned, Diagnosis Cover component of the insurance is the sum payable to you if you test positive for a disease but are not eligible for hospitalization or long-term care. This cover will be 2% of the total insured amount, and a beneficiary can only be eligible for the diagnosis cover once in the policy year.
• Diagnosis required: In order to be eligible for these payments, insurance companies will be free to create some guidelines and rules. One of the most common of these will be that all treatment, diagnosis, and, if necessary, hospitalization has happened at allopathic medical centres. For example, in order to be eligible for diagnosis cover, one must have a medical report and diagnosis from a licensed allopathic doctor.
• Policy duration: Like all other standard health insurance policies, the Standard Vector-Borne Disease Health Policy will also be applicable for a specific duration. The minimum duration set for the policy is one year or 12 months. Insured person(s) will be allowed to renew the Standard Vector-Borne Disease Health Policy subject to their eligibility as per the guidelines of the insurance company.
• Sum Insured: The minimum coverage amount under Standard Vector-Borne Disease Health Policy is set at ₹10,000. The upper limit for the sum insured has been set at ₹2 lakhs. As per the guidelines of IRDAI, whatever is the sum insured you decide on, it must be in multiples of ₹10,000.
• Coverage: The guidelines state that this is a single premium policy. That means that after 15 days of payment of the premium, the policyholder will become eligible for compensation upon diagnosis with the vector-borne disease, subject to the conditions specified in the policy. However, if you are diagnosed with the disease before the 15 days are up, then the insurance company will not provide you with any compensation.
• Entry Age: As per the guidelines of IRDAI, the entry age for the policyholder under Standard Vector-Borne Disease Health Policy is 18 years. The maximum age at the time of entry is 65 years for all the members covered under the policy. Dependent children are covered under the policy from Day 1 of age till the age of 25 years.
• Termination of policy: After payment of 100% of the sum insured, the policy will be considered to be terminated for the policy year. If the policy is issued for a family where there is a separate sum insured for every member, the policy will continue to be in effect for rest of the insured persons.
  

Exclusions under the Standard Vector-Borne Disease Health Policy

There are some exclusions that are applicable to the Standard Vector-Borne Disease Health Policy:

• Claims filed for treatment of many diseases other than for vector-borne diseases that are covered under this policy.
• Diagnosis or treatment of the specified ailments at a hospital located outside the geographical limits of India.
• Any diagnostic tests that are not recognized or approved by the state or central government in India.
• Expenses incurred for unproven treatments, i.e., treatments that lack substantial documentation in support of the effectiveness.

Standard Vector-Borne Disease Health Policy is a medical insurance plan for vector-borne diseases that ensures that you and your family do not have to suffer needlessly. Being prepared will allow you to focus on recovering with quality medical care rather than worry about your finances!