Covid health insurance claims near 1 lakh as private treatment grows – Times of India

MUMBAI: Health insurance claims related to Covid-19 are inching towards the one-lakh mark, with the value of the claims at around Rs 1,400 crore. Even as Mumbai continues to lead in the number of cases, claims from Delhi and Chennai are steadying, while Bengaluru private hospitalisation claims are on the rise.
Around to data collated by the General Insurance Council, 85,000 cases were reported up to Tuesday, which is for a value of around Rs 1,400 crore. On an average, 2,000 claims are being reported per day out of the 50,000-odd positive results.
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Insurers said the sharp jump in the number of claims is because of treatment shifting from government to private hospitals. For instance, in Bengaluru until recently most treatment was happening in government centres, however, now there are around 5,000 patients in private hospitals.

At current levels, claims are relatively low compared to the Rs 51,000-crore size of the country’s health insurance market. Despite the rise, insurers are not expecting a surge in claims for two reasons. First, there are indications that Covid-19 is slowing in metros and moving to interiors where insurance penetration is lower. Second, the local administration is increasingly prescribing home treatment.
According to Bajaj Allianz General Insurance health claims head Bhaskar Nerurkar, there is a slight tapering in claims being registered. “Earlier, claims were doubling in 15-16 days and now it is taking 21 days. Part of the reason could also be that home quarantine is being increasingly recommended for asymptomatic cases,” he said.
While home treatment is also covered as insurers reimburse cost of home treatment packages (which are usually under Rs 15,000), these claims are lodged after recovery when the claimant submits documents. In the case of hospitalisation, most claims are cashless and recorded immediately. Bajaj Allianz has recorded around 3,000 claims, which is around 4% of its total claims.
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According to Atul Sahai, chairman, New India Assurance Company — the country’s largest non-life insurer, the claims received until recently would have been within Rs 100 crore. “A large part of our health insurance business is from group policies. Most of the Covid-19 claims are from individual policies,” said Sahai. One reason for lower group claim is believed to be the fact that such policies are taken by service firms, which have shifted to a work-from-home mode.
According to PWC leader — insurance Joydeep Roy, only 14-16% of Indians have health insurance with premiums worth Rs 51,637 crore and 80% of the premium is paid out as claims. As against this, the hospital industry is around Rs 4 lakh crore.

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