Page 9 - Insurance Times November 2021

Health Insurance

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Insurers' Covid claims cent because non-Covid claims are death. The ex-gratia compensation is
back on track," said Bhaskar Nerurkar, to be disbursed within 30 days from the
outgo falls head of health claims, Bajaj Allianz date of submitting the application to
The General and health insurers have General Insurance. the concerned District Disaster Man-
seen a fall in their outgo of Covid-re- "Since Covid cases are declining across agement Authority/District Adminis-
lated health claims after the second tration along with the proof of the
the country, such claims will come
wave. death of the deceased due to Covid-19
down gradually. However, we are see-
In the July-September quarter (Q2 of ing dengue infections rising in some and the cause of death being certified
FY22), insurers settled a little over Rs pockets. So, we are expecting more as "Died due to Covid-19", the apex
5,000 crore worth of Covid health than usual claims. So far in H1 of FY22, court said.
claims. This is 35 per cent lower than we have crossed 68 per cent of last The amount shall be provided by the
the Rs 7,700 crore worth of claims they year's claims and by the end of FY22, concerned states from the State Disas-
settled in Q1, sources said. we expect 120-130 per cent of last ter Response Fund and is to be dis-
Insurers have settled around 6.2 lakh year's claims," he added. bursed by the District Disaster Man-
Covid health claims in Q2 compared to The chief executive officer (CEO) of a agement Authority/District administra-
7.8 lakh in Q1. So, in the first six private insurer said hospitals have in- tion.
months of FY22, insurers have settled creased their rates, and this is evident "No States shall deny the ex-gratia
1.4 million claims worth Rs 12,702 from the fact that the cost per claim
crore, which is significantly higher than has gone up by 20-30 per cent. How- assistance of Rs 50,000 to the next of
what they settled in the last financial ever, hardly any insurance company the kin of the deceased died due to
year. In FY21, the insurers settled has raised prices on its old products. Covid-19 solely on the ground that in
849,034 claims amounting to Rs 7,833 Hence, this will put pressure on profit- the death certificate issued by the ap-
crore. ability. propriate authority, the cause of death
is not mentioned as 'Died due to Covid-
Insurance industry insiders said that
while Covid cases came down signifi- Covid deaths: State 19'," the apex court said.
cantly, post the second wave, the The top court also said that if a family
claims trajectory did not follow the should not deny Rs. 50,000 member of the deceased who commit-
same path because there is a lag in ex-gratia, says SC ted suicide within 30 days from being
submitting claims.
The Supreme Court said no state shall diagnosed as Covid-19 positive shall
"If we compare Q2 with Q1 of FY22, deny the ex-gratia compensation of Rs also be entitled to avail the financial
Covid-19 claims have fallen by almost 50,000 to the next of kin of the de- help/ex-gratia assistance of Rs 50,000
35 per cent, but non-Covid claims have ceased due to Covid-19 solely on the as granted under the SDRF in accor-
increased 73 per cent. So, overall, the ground that death certificate does not dance with the guidelines issued by the
health claims have increased by 27 per mention the virus as the cause of NDMA.

The Insurance Times, November 2021 9