Do Covid-specific insurance policies cover black fungus?

As the second wave of Covid-19 weakens in the country with 92,719 new cases reported on Wednesday, India is grappling with a new problem: Mucormycosis. It is a rare fungal disease with a high mortality rate of around 50%. According to the latest numbers, there are more than 28,000 cases of fungal infection in India. Out of this, 86% or 24,370 cases suffered Covid-19 and 62.3 % or 17,601 have diabetes.

Mucormycosis is a serious but rare fungal infection that happens after getting in contact with the fungal spores in the environment. It affects eyes causing blindness, nasal cavity and other severe medical conditions. High doses of steroids and diabetes are considered to be major reasons for the infection.

Considering Mucormycosis treatment generally involves surgery with a long stay in a hospital, experts say treatment for the fungal infection could be very costly. In the absence of an insurance policy, it can leave the family with a big hole in their pockets. But do the covid-specific policies covers Mucormycosis?

While comprehensive insurance policies cover Mucormycosis, covid-specific plans which were launched last year specifically for the coverage of the virus do not cover the fungal infection.

“Mucormycosis is not Corona but it happens after Corona. It is a different disease due to which it is not covered under Covid Kavach. However, if you have a comprehensive health insurance policy then you can be assured that your policy will cover it. In case of hospitalisation or other problems, it is covered under the comprehensive policy by the insurance company. The only thing which one should remember is that there is a waiting period of 30 days for all illnesses except accident. The same waiting period applies over here up to the sum insured,” Amit Chabbra, Business Head – Health, Policybazaar, told Money 9.

Another area of concern could be the growing cases of black and white fungus among newborn babies. “Cases have been reported where the black fungus was reported even in a newborn baby. Now the basic insurance policy covers a newborn only after 90 days. In such cases the coverage for a newborn child can be disputed,” said S. K. Sethi, director and founder, RIA Insurance Brokers.

Mucormycosis is commonly referred to as black fungus, including white, yellow and even green fungus. Gurdeep Singh Batra, Head – Retail Underwriting, Bajaj Allianz General Insurance said, “At Bajaj Allianz General Insurance, our health indemnity policies cover hospitalization expenses with respect to various infections. Mucormycosis is considered an infection and hence will be covered under our health indemnity policies. We have already settled many claims arising towards this infection.”

Claim Process

The claim process for black fungus treatment is similar to any other hospitalisation. You need to inform your insurer or Third Party Administrator (TPA) in advance for the same. Nikhil Chopra, Chief Business Officer, Medi Assist Healthcare Services said, “Comprehensive health insurance policies cover black fungus infection. The treatment of the disease warrants a minimum of 24 hours of hospitalization. The policyholder, however, will have to intimate the TPA about any previous underlying illnesses, whether this is a planned or an emergency hospitalization, and submit all necessary documents to raise a claim. The claims process will be the same as it is for all illnesses covered under the comprehensive health policies.”