How effective is Insurance in Covid: Important to know

The real test of an insurance policy is when a claim is filed. There are many instances when, in some cases, the claim made on the policy is rejected despite no apparent fault of the policyholder or even the policyholder’s nominee.

Today it is being discussed here because the concerns of the people regarding insurance policy claims are increasing, especially in this uncertain time of the pandemic.

Remember that an insurance policy (whether it relates to life, health, property or automobile) is a financial contract between the policyholder and the insurer, in which the insurer will pay financial consideration to the policyholder or their nominee in case of a claim arising according to the policy agreement.

So if you have health insurance that promises to cover the money you spend on treatment if you are hospitalized due to health problems, the insurer will cover your hospitalization bills, subject to the limit of policy benefits. will pay

Sometimes there is a difference between what the actual insurance policy benefits are and what you think about it. This is especially true in the case of medical insurance, where policyholders often assume that the cost of treatment for each illness will be covered by the policy.

And, policyholders feel cheated when their claim is rejected by the insurer because the claim is outside the scope of the insurance contract.

For example, take the case of a fracture caused by a fall from a ladder, in which case you will go to the hospital and get an X-ray and a bandage, this treatment is not covered by most medical insurance.

Reason– In this situation hospitalization is not required for 24 hours, which is the basic condition of the medical insurance claim to be paid.

If you are on a WhatsApp group or other social media, chances are you have also received a message saying that two popular Prime Minister’s (PM) schemes– Pradhan Mantri Jeevan Jyoti Bima Yojana (PMJJBY) and Pradhan Mantri Suraksha Bima Yojana (PMSBY) )- but can be claimed for Covid related deaths.

The social media post even states that if a close relative/friend has died due to COVID or other reasons, they can make entries of Rs 12 or Rs 330 during the entire financial year to claim an insurance benefit of Rs 4 lakh You can check your bank account details or passbook entries for.

It is true that in the year 2015, the government had launched the above two schemes under the Jan Dhan-Jan Suraksha Yojana to provide social security at an affordable premium to the citizens across the country having savings bank accounts.

But out of this only deaths related to COVID are covered under PMJJBY subject to eligibility and claim process.

While this is not the case with PMSBY, which provides an insurance cover of Rs 2 lakh for accidental death or total permanent disability of people in the age group of 18 to 70 years.

Since death related to COVID does not come under accidental death; Hence it cannot be claimed under PMSBY. So even in cases of COVID deaths, and if the bank account holder has availed the benefits of PMJJBY and PMSBY, their nominee can claim a maximum of Rs.2 lakh.

However, PMJJBY is available to those in the age group of 18 to 50 years, who have a bank account and who give their consent to join/auto-debit this insurance policy.

Also, there is no such policy document in the case of this policy as an individual insurance policy document, which means that many account holders may not even be aware of the policy.

Also, as per the policy details, the life cover of Rs 2 lakh under this policy is valid for a period of one year (from June 1 to May 31) and then the policy has to be renewed.

Under this plan, there is a risk coverage of Rs 2 lakh in case of death of the life assured due to any reason and the annual premium is Rs 330.

This policy is available to the account holder up to the age of 55 years and not more than that. This means that people who have bank accounts and are 55 years old, and who have unfortunately become victims of covid; They will not get the benefit of this policy nor can they make any claim.

Information on Government’s Social Insurance and Pension Schemes  https://jansuraksha.gov.in/Jan-Dhan Se Jan Suraksha Renewal of PMJJBY & PMSBY Schemes open for the period of 21st May 2017 to 31st May 2017. Please ensure to Auto-Debit Your account can be accessed accordingly.

If an individual is eligible for the policy, then their nominee as mentioned in the bank account needs to file a claim at the concerned bank branch where the underlying account exists within 30 days of the death of the account holder.

So those who have lost their family members due to COVID, can they get insurance benefits for claiming under these schemes?

PMJJBY is managed by the Life Insurance Corporation of India (LIC), which is under state ownership, so the chances of settlement of insurance claims are not doubtful.

However, the claim process and the paperwork involved, especially in situations where the account holder no longer resides at the same address as the account, can make claims difficult at times.

In case of such calamities, claims are automatically paid to the nominee as soon as the policyholder’s account is closed due to death instead of requiring the nominee and family members to claim a policy. This will be of great help.