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Last Updated : Sep 03, 2020 10:17 AM IST | Source: Moneycontrol.com

Insurers face massive rise in non-COVID-19 claims in July, but health coverage still low

The claims are mainly for treatments of cancer, dialysis, cataract surgeries and cardiac ailments

Amit Chhabra 

COVID-19 positive cases in India have surged past the 3.65 million figure. In the last few months, only a little more than 1 lakh people have so far utilised their health insurance policies for the treatment of the novel coronavirus. According to numbers collated by insurance companies, approximately only 1,00,000 claims have come to insurers for a settlement involving a cumulative amount of Rs 1,644 crore—this works out to an incurred expenditure of Rs 1.64 lakh, on an average, per policyholder. The 1 Lakh claims when viewed against the over 3.65 million COVID-19 cases translate to just 2.7 per cent of the individuals who tested positive and had some kind of health insurance coverage.

On the other hand, general and specialised health insurers are witnessing a steady rise in non-COVID-related medical insurance claims as normalcy returns after the stringent lockdown was eased by the government. There has been a 64 per cent increase in July for such claims versus average claims in April, May and June. Of these claims, only 10 per cent are COVID-19 related. The rise in claims is mostly coming from elective procedures that were postponed on account of COVID-19 in the last few months. During the lockdown period, non-life insurers saw an almost 40 per cent drop in non-COVID claims. The claims are mainly for treatments of cancer, dialysis, cataract surgeries and cardiac ailments.


Time to prioritise health insurance

COVID-19 Vaccine

Frequently Asked Questions

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How does a vaccine work?

A vaccine works by mimicking a natural infection. A vaccine not only induces immune response to protect people from any future COVID-19 infection, but also helps quickly build herd immunity to put an end to the pandemic. Herd immunity occurs when a sufficient percentage of a population becomes immune to a disease, making the spread of disease from person to person unlikely. The good news is that SARS-CoV-2 virus has been fairly stable, which increases the viability of a vaccine.

How many types of vaccines are there?

There are broadly four types of vaccine — one, a vaccine based on the whole virus (this could be either inactivated, or an attenuated [weakened] virus vaccine); two, a non-replicating viral vector vaccine that uses a benign virus as vector that carries the antigen of SARS-CoV; three, nucleic-acid vaccines that have genetic material like DNA and RNA of antigens like spike protein given to a person, helping human cells decode genetic material and produce the vaccine; and four, protein subunit vaccine wherein the recombinant proteins of SARS-COV-2 along with an adjuvant (booster) is given as a vaccine.

What does it take to develop a vaccine of this kind?

Vaccine development is a long, complex process. Unlike drugs that are given to people with a diseased, vaccines are given to healthy people and also vulnerable sections such as children, pregnant women and the elderly. So rigorous tests are compulsory. History says that the fastest time it took to develop a vaccine is five years, but it usually takes double or sometimes triple that time.

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Despite a rise in claims in the last two months, the insurance penetration in the country still seems to be low. Health insurance claims made till now are only 2.7 per cent of the total number of people who have been infected with the virus till now. While it is important to follow all government advisories to protect yourself physically from getting infected with the coronavirus, it is also very important to stay financially protected against not just the pandemic, but all other ailments as well. This is because the COVID-19 pandemic may end in a couple of more months, but other lifestyle diseases and age-related ailments can affect you any time and it is very important to stay adequately protected against any such ailment. The only and most convenient way to stay financially protected is by buying an adequate health insurance policy.

Just like all other medical expenses for hospitalisation, if one gets hospitalised for treating coronavirus infection, the health insurance plan will help safeguard medical expenses. Buying a health insurance plan not just for yourself but for your entire family is important to make sure your hospital admission and treatment expenses are covered seamlessly. Your health insurance policy will cover you for testing and the cost of treatment for the novel coronavirus and any other disease. On the directions of the Insurance Regulatory and Development Authority of India (IRDAI), all the general and specialised health insurers have been advised to process all claims related to COVID-19 within two hours of the claim request.

Choose a plan at the right cost

In order to avail adequate coverage against all ailments including COVID-19, it is best advised to buy a comprehensive health insurance policy with a maximum sum insured. A regular health insurance policy with Rs 10 Lakh sum insured for a 32-year-old individual costs Rs 7,000-9,000 annually. However, if you feel you cannot afford to pay the entire amount as a lump sum, you may choose to pay the premium in monthly or quarterly payments as per your own convenience. Amidst the ongoing COVID-19 outbreak, the Insurance Regulatory and Development Authority of India (IRDAI) has come out with a circular for minor modifications in policies filed by general and standalone health insurers. As per the circular, the regulator has allowed the payment of health insurance premiums in instalments.

However, considering the financial stress due to job losses, sales dip and pay cuts that most salaried professionals and businessmen are facing all across the nation due to the corona crises, on the direction of the IRDAI, insurers have come up with standard COVID-19 specific plans that provide adequate coverage against the novel coronavirus. These are short-term plans available for a period of 3.5 months, 6.5 months and 9.5 months with a sum insured ranging from Rs 50,000 to Rs 5,00,000.  You can buy these plans for now and later opt for a comprehensive health cover at affordable prices.
(The writer is Health Business Head, Policybazaar.com)
First Published on Sep 3, 2020 10:17 am