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Regular-article-logo Monday, 25 November 2024

Reimbursement shock for coronavirus insured

Corona Kavach was launched on July 10 by the Insurance Regulatory and Development Authority

Sanjay Mandal Calcutta Published 30.09.20, 02:06 AM
The company earned approximately Rs 31 crore from premiums paid for the product by insurers.

The company earned approximately Rs 31 crore from premiums paid for the product by insurers. Shutterstock

A medical insurance policy launched for Covid-19 has found many takers but hospitals say the expectation that is driving the sale — that the policy will cover the entire treatment cost — is often proving to be misplaced.

The brisk sale of Corona Kavach stands in contrast to a drop in the renewal of regular health insurance policies of some companies, which are getting requests from policy-holders to defer the deadline for payment of their annual premiums.

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Corona Kavach was launched on July 10 by the Insurance Regulatory and Development Authority. Till September 28, National Insurance Company Ltd sold around 60,000 policies across India, of which 22,000 were sold in Calcutta, said officials.

The company earned approximately Rs 31 crore from premiums paid for the product by insurers. Around Rs 14 crore came from those who took out the policy in Calcutta, the officials said.

In comparison, Arogya Sanjeevani, a general health insurance policy launched by the company on April 1, has found as few as 331 takers till date across India.

“We have not seen this kind of response for any other health policy. As against this, there is a 10 per cent drop in renewal of some other health policies. Some of the customers have shifted to other companies because of lower premiums, while others are yet to make their annual payments because of finan-cial distress caused by the Covid-19 pandemic,” said Saurav Kariwala, assistant manager (medical), National Insurance Company Ltd, Calcutta.

Other insurance companies, too, said they were doing brisk business with Corona Kavach. Gariahat resident Debshankar Sinha said he had several health insurance policies for him and his wife and son. The insured amount for each is Rs 5 lakh.

“I bought the Corona Kavach policy of Rs 5 lakh each for a duration of nine-and-a-half months. The terms of the policy say there are no cappings. In other health insurance policies, there are cappings on bed charges and other expenditures,” said Sinha.

“I opted for this policy because there are no such cappings. Besides, it also provides coverage for getting treated for Covid at home.”

Insurance company officials said that unlike other health insurance policies, most people were making their own decisions to buy Corona Kavach and not taking advice from their agents.

“We are observing that most people are buying the policy online after reading about its benefit. They are not depending on agents, unlike for other policies,” said Prabir Mukherjee, general manager, medical, eastern region, Star Health and Allied Insurance.

The company, he said, has so far processed 42 Corona Kavach claims in Calcutta.

An official of another private insurance company said the denial of claims by insurance companies for Covid patients had made many people apprehensive about whether they would get enough reimbursements for Covid treatment.

“Normal health insurance policies are now covering Covid treatment as well. Inadmissible amounts in a bill of a Covid patient vary between 10 and 15 per cent, which include some consumables. The concern expressed by Covid patients and their families is about the long hospital stay, which raises the bill,” said R. Venkatesh, regional director, eastern region, Narayana Health. “Earlier, the inadmissible amount was much more but now some consumables are covered,” he said.

According to Venkatesh, in normal policies a patient can get reimbursement of up to one per cent of the sum insured as bed charge per day for non-ICU treatment and up to two per cent for ICU treatment. “But for Corona Kavach there are no such cappings,” he said.

Many hospitals like AMRI and ones run by Narayana Health are yet to get any patient with Corona Kavach but those who have said in-surance companies were denying payment under the policy.

“We had two patients whose claims under Corona Kavach policy were rejected,” said Sudipta Mitra, the chief executive of Peerless Hospi-tal. One of the patients was admitted on September 15 and discharged on Tuesday. He suffers from chronic renal disease and undergoes dialysis.

“The private insurance company denied the claim under Corona Kavach because they said the patient did not disclose his renal ailment. The patient then filed his claim under a general health insurance policy of the same company and got the reimbursement,” said Mitra.

“As for the other patient, the insurance company approved reimbursement after a rejection.”

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