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CHENNAI/BENGALURU: After a four-month lull, insurance claims for hospitalisation are gathering pace, for both Covid as well as non-Covid treatments. While the number of claims on account of the pandemic crossed 1.5 lakh (Rs 2,000 crore in value), the number of non-Covid claims is almost back at pre-lockdown levels but with the average claim size increasing 25%.
This is a trend shift from the first four months of the lockdown where health insurance claims shrank as policyholders delayed elected procedures like cataract, knee-replacement surgeries were postponed, and hospitalisation for accidental injury or infectious diseases were fewer because of the lockdown. Also, insurers did not face Covid claims in the first quarter as most of the treatment was undertaken at government facilities. Health claims had dropped to 50% of pre-Covid monthly average in April-May, rose after Unlock 1.0 to 85% in June, and returned to the earlier average in July, said Cholamandalam MS General Insurance MD Suryanarayanan V. According to Star Health and Allied Insurance MD S Prakash, average claim size of (non-Covid) hospitalisation is now Rs 51,000 from Rs 41,000 earlier because of mandatory Covid-19 tests, personal protective equipment costs and staff-handling charges. Of the 1.5 lakh Covid claims so far, 1.2 lakh cases (Rs 1,625 crore in value) are those reported by insurers to the General Insurance Council. The remaining 30,756 are under Ayushman Bharat, according to National Health Authority (NHA) data.
Of the 23 lakh people tested positive, only about 16 lakh have required hospitalisation, and of these only 10% are covered under insurance, NHA said. This could rise to 15% as reliance on Ayushman Bharat increases in tier-2 and -3 cities, along with rural areas. Under the Ayushman Bharat scheme, more than 12 crore e-cards have been issued to beneficiaries with over 1 crore admissions since the start of the scheme in September 2018. The non-Covid claims, which rose in July, include those for cancer surgeries & chemotherapy, emergency general procedures, and surgeries like removal of appendix & gallbladder, cardiac consultations and emergency cardiac surgeries. “We saw non-Covid claims fall sharply in April. However, the rate of these claims doubled in June and again in July. Today, we have close to about 20 lakh claims as markets and malls have opened up,” said Max Bupa Health Insurance director Bhabatosh Mishra.
Bajaj Allianz General’s claims in July are 64% over the first quarter average. “We have witnessed an approximately 12% increase in the average claim size recorded in the first quarter of FY21, as compared to last year,” said head (health) Bhaskar Nerurkar. The industry average health Insurance claims settled ranges between Rs 55,000 and Rs 1 lakh before the pandemic.
This is a trend shift from the first four months of the lockdown where health insurance claims shrank as policyholders delayed elected procedures like cataract, knee-replacement surgeries were postponed, and hospitalisation for accidental injury or infectious diseases were fewer because of the lockdown. Also, insurers did not face Covid claims in the first quarter as most of the treatment was undertaken at government facilities. Health claims had dropped to 50% of pre-Covid monthly average in April-May, rose after Unlock 1.0 to 85% in June, and returned to the earlier average in July, said Cholamandalam MS General Insurance MD Suryanarayanan V. According to Star Health and Allied Insurance MD S Prakash, average claim size of (non-Covid) hospitalisation is now Rs 51,000 from Rs 41,000 earlier because of mandatory Covid-19 tests, personal protective equipment costs and staff-handling charges. Of the 1.5 lakh Covid claims so far, 1.2 lakh cases (Rs 1,625 crore in value) are those reported by insurers to the General Insurance Council. The remaining 30,756 are under Ayushman Bharat, according to National Health Authority (NHA) data.
Of the 23 lakh people tested positive, only about 16 lakh have required hospitalisation, and of these only 10% are covered under insurance, NHA said. This could rise to 15% as reliance on Ayushman Bharat increases in tier-2 and -3 cities, along with rural areas. Under the Ayushman Bharat scheme, more than 12 crore e-cards have been issued to beneficiaries with over 1 crore admissions since the start of the scheme in September 2018. The non-Covid claims, which rose in July, include those for cancer surgeries & chemotherapy, emergency general procedures, and surgeries like removal of appendix & gallbladder, cardiac consultations and emergency cardiac surgeries. “We saw non-Covid claims fall sharply in April. However, the rate of these claims doubled in June and again in July. Today, we have close to about 20 lakh claims as markets and malls have opened up,” said Max Bupa Health Insurance director Bhabatosh Mishra.
Bajaj Allianz General’s claims in July are 64% over the first quarter average. “We have witnessed an approximately 12% increase in the average claim size recorded in the first quarter of FY21, as compared to last year,” said head (health) Bhaskar Nerurkar. The industry average health Insurance claims settled ranges between Rs 55,000 and Rs 1 lakh before the pandemic.
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