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Last Updated : Jul 22, 2020 11:04 AM IST | Source: Moneycontrol.com

COVID-19 effect: Insurers reluctantly offer medical cover to healthcare professionals

The regulator has sternly asked insurers not to discriminate against medical professionals while processing insurance proposals

After dragging their feet over insuring healthcare workers during the COVID-19 pandemic, general insurers seem to more open to the idea now.

Healthcare professionals, including doctors, nurses and paramedical staff are seen as high-risk customers due to the environment they operate in, particularly in the current scenario. According to the Indian Medical Association, 99 doctors have lost their lives due to the pandemic in India so far. The association also issued a red alert asking medical professionals to raise their guard.

Coverage denial


There were instances of insurers denying coverage altogether to medical professionals after the COVID-19 outbreak in India. Recently, the Insurance Regulatory and Development Authority of India (IRDAI) sought responses from insurers on whether they were denying coverage to healthcare workers. “The regulator has sternly asked insurers not to discriminate against medical professionals while processing insurance proposals,” said a senior industry executive, requesting anonymity.

Now, the Association of Medical Consultants, Mumbai, is on the verge of signing an agreement with a private insurer to provide Rs 1-lakh Corona Rakshak cover to healthcare workers employed with its member hospitals in Mumbai. The premiums, funded by owners of hospitals and nursing homes, will be linked to the age of hospital staff who enroll for the scheme.

This comes in the backdrop of the IRDAI mandating non-life insurers to offer standard, reimbursement-based Corona Kavach policies to pay for COVID-19 treatment expenses. The insurance regulator has also allowed all insurers to sell Corona Rakshak, a benefit-based health insurance policy, that hands out the entire sum insured if the policyholder tests positive and is hospitalised for at least 72 hours. Insurers will have to provide 5 per cent discount on premiums to healthcare workers.

However, convincing insurers to extend this cover was not an easy task. “We negotiated with multiple government and private insurers initially, but could not make much headway. They were reluctant to cover hospital staff in large numbers through us. In fact, we had almost tied up with one private insurer for a group cover, but they pulled out at the last minute citing unviability, just when we were about the make the premium payment,” says Dr Sudhir Naik, Chairman, Medico-Legal Cell, Association of Medical Consultants, Mumbai. The organisation represents doctors practising at government, corporate and tertiary care hospitals as also individual consultant doctors with their own nursing homes in Mumbai, Navi Mumbai and Thane.

Taking additional insurance

This apart, the association has also purchased a Rs 7-lakh group super top-up health cover from the state-owned Oriental Insurance for its member-doctors part of the association. “It is a group cover. Member doctors have to pay an annual premium of Rs 6,500 for this super top-up cover, which will be triggered after our individual base policy of Rs 3 lakh is used up,” says Dr Narendra Dedhia, member of AMC and President, Indian Medical Association, Central Suburbs. It will be a one-time policy, valid up to May 31, 2021.

On their part, insurers say they are open to issuing policies to individuals across professions. “We do not discriminate against any profession. We only take into account the health parameters at the time of underwriting. As long as their answers to our questions on their health and medical test results meet our underwriting criteria, we do issue policies,” says Nikhil Apte, Chief Product Officer, Health, Royal Sundaram General Insurance. Through the underwriting process, insurers assess prospective policyholders’ health parameters, decide whether or not to issue policies and also determine the premiums to be charged.

While insurers are coming forward to issue policies to healthcare professionals, others in the medical fraternity believe the central and state governments should take on the responsibility of insuring doctors and other medical staff. “At present, it’s the hospitals that are taking care of their staff in case they get infected. Ultimately, this increased cost is passed on to patients. Governments must take charge and provide life as well as health insurance covers to medical professionals,” said Alexander Thomas, President, Association of Healthcare Providers India.
First Published on Jul 22, 2020 11:04 am