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Does your insurance policy cover mental health ailments?

Some policies have made some progress in terms of taking mental healthcare in the ambit of insurance by covering up to 25 percent of the sum insured in case of hospitalisation.

June 21, 2021 / 20:58 IST
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To say that the pandemic has taken a serious toll on our mental health would be an understatement. In fact, data suggests that ever since Covid-19 gripped our lives, sales for antidepressants have steadily risen to 23 percent, from Rs 189 crore (April 2019) to almost Rs 218 crore this month, as per research reports by All Indian Origin Chemists and Distributors (AIOCD). 

Even NIMHANS (The National Institute of Mental Health and Neuro-Sciences) reported a sharp increase in its helpline and tele-consultancy calls, from 1,085 per day in March to almost 2,000 in the same period in April 2021. 

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A 2019 ICMR-PHFI report shows that almost 197.3 million people in the country suffer from various kinds of mental diseases. Adding to this already grim Indian mental health scenario is the bare implementation of the 2018 IRDAI (Insurance Regulatory and Development Authority of India) directive which places mental and physical health on the same pedestal and mandates all insurance providers to make provisions for mental health conditions in the policy as well. 

In fact, in its circular titled “Guidelines on Standardization of Exclusions in Health Insurance Contracts'' dated September 27, 2019, the apex regulatory body has made it clear that the treatment of mental illness, stress, or psychological disorders, and neurodegenerative disorders cannot be excluded. 

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In a recent verdict in the case of Shikha Nischal vs National Insurance Company (April 2021), where the appellant was denied hospitalisation expenses for schizoaffective disorder by NIC, stating that no coverage would be provided for ‘psychiatric disorder’, the Delhi High court noted that: “Mental illnesses cannot be treated differently from physical illnesses. Insurance policies also cannot discriminate between these two types of illnesses. Mental illnesses can also be debilitating and destructive. The recent pandemic also highlights this beyond any doubt. Circumstances leading to patients requiring isolation, healthy persons being subjected to lock-downs, work from home conditions, loss of employment leading to lack of confidence for long durations have led to several mental problems. Availability of insurance for mental disabilities or conditions is, therefore, not only important but is an essential need.”