FAQs on ManipalCigna Health Insurance Products

Frequently Asked Questions

Corona Kavach Policy, ManipalCigna also known as Covid standard health insurance policy is developed by IRDAI and made available by ManipalCigna Health Insurance Company. It is designed to cover COVID related hospitalization/home care treatment expenses. The policy also provides coverage towards Pre and Post hospitalization, Road ambulance, AYUSH treatment with an option of Hospital daily cash.

You can contact our sales advisor at any of our branches (list available on website www.manipalcigna.com) or can call our Toll free customer care number 1800-102-4462 for details.

The minimum entry age is 1 day for children and 18 years for adults. Maximum entry age limit for adults is 65 years. Dependent Children will be covered up to 25 years in a floater policy.

 Policy can be bought on an Individual basis as well as on family floater basis.

Individual plan can be bought for self, lawfully wedded spouse, dependent children, parents, parent in laws.

A family floater plan can cover self, lawfully wedded spouse, dependent children up to the age of 25 years, parents, parent in laws. A floater cover can cover a maximum of 2 adults and 3 dependent children under a single policy.

No PPMC will be required for this policy.

5% discount in premium shall be provided to health care workers.

Health care workers include - Doctors, AYUSH practitioners, Physiotherapists, Nurses and Midwives, Pharmacists, Ward boys and orderlies, Lab Assistants, Lab technicians, Dentists, Hospital employees, Diagnostic center employees, Pharmacy employees, ASHA, health workers and Aanganwadi workers.

This policy is available for 3 ½ months (105 days), 6 ½ months (195 days) and 9 ½ months (285 days).

Following are the coverages available under the policy

  1. Covid Hospitalization Cover
  2. Home Care Treatment Expenses
  3. Ambulance Cover
  4. AYUSH Treatment
  5. Pre Hospitalization
  6. Post Hospitalization
  7. Hospital Daily Cash (optional)

Home Care Treatment means treatment availed by the Insured Person at home for Covid on positive diagnosis of Covid in a Government authorized diagnostic Centre, which in normal course would require care and treatment at a hospital but is actually taken at home provided that:

a. The Medical practitioner advices the Insured person to undergo treatment at home.

b. There is a continuous active line of treatment with monitoring of the health status by a medical practitioner for each day through the duration of the home care treatment.

c. Daily monitoring chart including records of treatment administered duly signed by the treating doctor is maintained.

Coverage available maximum up to 14 days per incident, including pre-hospitalization expenses for a period of 15 days and post hospitalization expenses for a period of 30 days.

In case of Covid hospitalization, patient can stay at the hospital until the recovery. There is no such restriction on number of days. Coverage available maximum up to the Sum Insured and shall be a part of the overall sum insured in the policy.

Following is a partial list of the policy exclusions. Please refer to the policy terms and conditions available on our website www.manipalcigna.com (download section) for the complete list of exclusions:

a. Admission primarily for investigation & evaluation
b. Admission primarily for rest Cure, rehabilitation and respite care
c. Any claim in relation to Covid where it has been diagnosed prior to Policy Start Date.
d. Day Care treatment and OPD treatment

Any expenses incurred on OPD basis will not be covered under this policy. Only medically necessary treatment certified by registered medical practitioner in pre-hospitalization and post-hospitalization period will be covered.

Hospital Daily Cash is available under optional cover. 0.5% of sum insured per day for each 24 hours of continuous hospitalization is available provided company has accepted in-patient hospitalization claim.

Renewal is not available in this policy.

All medical treatment for the purpose of this insurance will have to be taken in India only.

In general, one has to submit a filled and signed proposal form along with a payment instrument to apply for health cover under this policy.

In case, any additional documents are required, we will contact you.

This policy constitutes the complete contract of insurance. This Policy cannot be modified by anyone (including an insurance agent or broker) except the company. Any change made by the company shall be evidenced by a written endorsement signed and stamped.

The policyholder may be changed during the Policy Period only in case of his/her demise or him/her moving out of India. The new policyholder must be the legal heir/immediate family member. Such change would be subject to acceptance by the company and payment of premium (if any).

Base cover under Corona Kavach Policy is offered on indemnity basis while optional cover of Hospital daily cash is available on benefit basis.

Yes, medical expenses incurred on hospitalization for COVID-19 treatment are covered on Positive diagnosis of Covid in a government authorized diagnostic center including the expenses incurred on treatment of any comorbidity.

The claim will be honored if you are hospitalized, subject to medical reports being positive for COVID-19 from a government authorized diagnostic center.

Yes. expenses incurred for road ambulance will be covered up to Rs. 2000 per hospitalization availed only in relation to Covid.

Only home care treatments on the advice of a registered medical practitioner and at a facility designated by the Government as hospital for the treatment of Covid positive insured person is covered under the policy.

Coverage includes:

i. Room Rent, Boarding, Nursing Expenses as provided by the Hospital / Nursing Home.

ii. Intensive Care Unit (ICU) / Intensive Cardiac Care Unit (ICCU) expenses.

iii. Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist Fees whether paid directly to the treating doctor / surgeon or to the hospital

iv. Anesthesia, blood, oxygen, operation theatre charges, surgical appliances, ventilator charges, medicines and drugs, costs towards diagnostics, diagnostic imaging modalities, PPE Kit, gloves, mask and such similar other expenses.

v. Road Ambulance subject to a maximum of Rs.2000/- per hospitalization

The medical expenses incurred for COVID hospitalization under AYUSH system of medicine will be covered in AYUSH hospital provided. Treatment taken in

a. Central or State Government AYUSH Hospital or

b. Teaching hospital attached to AYUSH College recognized by the Central Government/Central Council of Indian Medicine/Central Council for Homeopathy; or

c. AYUSH Hospital with in-patient healthcare facility of any recognized system of medicine, registered with the local authorities.

For details refer policy terms and condition available on our website www.manipalcigna.com (download section)

There is only single premium payment mode available under this policy.

One can claim under Cashless/Reimbursement basis under this policy.

Notification of claim with full particulars shall be sent to the Company/TPA.

i. In case of emergency hospitalization/cashless home care treatment within 24 hours.

ii. in case of a planned Hospitalization 48 hours prior to admit in Hospital.

For details refer policy terms and condition available on our website www.manipalcigna.com (download section)

The list of documents to be submitted includes:

i. Duly filled and signed Claim Form

ii. Copy of Insured Person’s passport, if available (All pages)

iii. Photo Identity proof of the patient (in case of no passport)

iv. Medical practitioner’s prescription advising admission

v. Original bills with itemized break-up

vi. Payment receipts

vii. Discharge summary including complete medical history

viii. Investigation reports from Authorized diagnostic centre for COVID

ix. OT notes or Surgeon’s certificate giving details (if operated)

x. Sticker/Invoice of the Implants, wherever applicable.

xi. NEFT Details (to enable direct credit of claim amount in bank account) and cancelled cheque

xii.  KYC (Identity proof with Address) of the proposer, where claim liability is above Rs 1 Lakh as per AML Guidelines

xiii. Legal heir/succession certificate, wherever applicable

xiv. Any other relevant document required by Company/TPA for assessment of the claim.

The list of documents to be submitted includes:

i. Duly filled and signed Claim Form

ii. Copy of Insured Person’s passport, if available (All pages)

iii. Photo Identity proof of the patient (in case of no passport)

iv. Medical practitioners’ prescription advising hospitalization

v. A certificate from medical practitioner advising treatment at home or consent from the insured person on availing home care benefit.

vi. Discharge Certificate from medical practitioner with date of start and completion of home care treatment.

vii. Daily monitoring chart including records of treatment administered duly signed by the treating doctor is maintained.

In the case of demise of the insured person coverage of policy automatically ends. However, in this policy cover will continue for the remaining Insured persons till the end of policy period. This is called as automatic change in coverage.

Pre hospitalization:  Medical expenses incurred 15 days prior to the date of hospitalization/home care treatment.
Post hospitalization:  Medical expenses incurred 30 days from the date of discharge from the hospital/completion of home care treatment.

Above treatment will get covered provided inpatient hospitalization/home care treatment claim is admissible by the Insurance Company.

One can avail tax benefit under sec.80 D as per IT Act. This section is subject to revision in tax laws.

If premiums are paid in cash no tax benefits are allowed under section 80D.

If you need to speak to us about the product, services or claims, contact our Customer Care Toll free 1800- 102- 4462 or you can write to us at customercare@manipalcigna.com for assistance.

The Sum Insured options available under this policy includes Rs. 50000, 1 lac, 1.5 lacs, 2 lacs, 2.5 lacs, 3 lacs, 3.5 lacs, 4 lacs, 4.5 lacs, 5 lacs.