In the midst of the second rise, with a rapidly increasing number of infections across the country, claims made under health insurance for Covid have reached 22,955 million rupees and 14.82 lakhs have presented hospital bills on May 14.
However, insurance companies have only resolved claims of 12.33 lakh customers for approximately Rs 11,794 crore so far, according to figures compiled by the General Insurance Council. Claims of more than 2.5 lakhs of customers involving 11,161 million rupees have not yet been cleared, according to the figures.
These are claims made by customers for the treatment of Covid in all insurance systems, including two specifically for Covid, since April 2020.
Among the states, Maharashtra leads with 5.35 lakh people filing claims worth Rs 6,896 crore on May 14, followed by Gujarat, Karnataka and Delhi (see chart). These five states account for 65% of all claims.
Although the average amount of Covid’s claim was 154,808 rupees in March 2021, the average amount settled was estimated at 95,622 rupees per person across India. Among the states, Telangana exceeded the established amounts with one person receiving 125,260 rupees for hospitalization and treatment, followed by Delhi with 121,540 rupees per person.
With the cases and claims, complaints have arisen from some insurance companies that refuse to renew or offer new Covid policies to customers, which has led to the Development and Security Authority of India (IRDAI). ) intervene.
“The Administration has learned that some of the insurers do not offer Corona Kavach and Corona Rakshak policies to customers and that some insurers do not renew these policies,” IRDAI said in a letter to insurance companies.
“Following the increase in infection rates due to the second wave of Covid-19, the insurable public requires adequate health insurance coverage and it is not right to deny such coverage to customers at this crucial time,” he said. to say.
All insurers are encouraged to ensure that wherever standard crown products have been submitted and approved by the Authority, they should be offered to customers in accordance with the insurer’s underwriting policy. .
“Similarly, when the specific product of the underlying crown allows the insured to renew the policy as specified in the IRDAI circular, insurers are recommended to renew these policies subject to the policy of the respective insurers. “said the Authority.
Industry sources told The Indian Express that insurers “have seen a boost in claims” under Covid’s policies.
“They don’t want to succeed in their books. Some insurers, including public sector companies, have refused to offer policies to customers as the Covid pandemic occurs, ”they said.
Corona Kavach and Corona Rakshak were launched by insurers under the guidance of IRDAI. Corona Kavach is an affordable policy that covers medical expenses arising from hospitalization due to the diagnosis of Covid. According to IRDAI, the cost of treatment for any comorbid condition, including pre-existing ones, along with treatment for Covid, will be covered by the policy.
State governments have also begun setting rates for various medical items used for Covid treatment. Recently, the Kerala government set the tariff for PPE equipment at Rs 273, N95 mask at Rs 22, oxygen mask at Rs 54, surgical gown at Rs 65, apron at Rs 12 and peak dust oximeter of the fingers at Rs 1,500.
IRDAI has ruled out a sharp rise in the premium on health insurance policies despite a rapid increase in claims by policyholders. Meanwhile, the total collection of premiums in the health insurance category by insurers amounted to Rs 58,572 million in March 2021, an increase of 13.3% compared to last year.
New India Assurance collected € 10,736 million followed by Star Health Insurance at € 9,204 million, according to Council data.