Page 14 - Insurance Times February 2021

Health Insurance

Covid survivors buying problems too. Some opt for reimburse- As per Chopra, a lot of this could be
new insurance cover face ment if the third-party administrators fixed if insurers and hospitals invest in
technology. He gave an example of
(TPA) take time to provide cashless facili-
exclusions ties in network hospitals," said Mahavir food delivery. "When you order from a
Covid-19 survivors who are planning to Chopra, founder, Beshak. restaurant, you can track the order in
buy new health insurance could face The report is compiled based on an real time. Insurers need to put real-
hurdles in future claims if their ailments online and telephonic survey of 530 time tracking systems for claims to
can be linked to the viral infection. individuals. Of these, 42% had group make the process smoother."
With the coronavirus affecting different insurance and 58% had personal Until insurers and hospitals improve
organs over time, future complications policies. A majority (53%) had policies their processes, there are bound to be
could be categorised as a 'pre-existing' from public sector insurers and the delays, and customers may choose to
condition by insurance companies. remaining (47%) from private opt for reimbursement claims instead
Insurers cover pre-existing diseases companies. of waiting to hear from the hospital's
only after a 'waiting period', which According to Chopra, a cashless facility billing desk that their claims are
varies from 2-5 years which is a is smoother for employer-provided settled.
standard clause in health policies. For insurance against a personal policy.
example, a person with bronchial That's because insurers and TPAs have Non-life insurers demand
asthma and is admitted in the ICU for better systems in place for corporate increase in tax deduction
Covid-19, any lung condition will be clients. Over half (52%) of the
endorsed as a 'pre-existing'. respondents said that they have faced Ahead of the Union Budget 2021-22,
General insurers have suggested that
Claimants prefer cashless problems in getting timely support the government increase the tax
from insurers or their TPAs. They had
claim settlement: Survey to repeatedly follow up during the deduction limit under Section 80D of
the Income-Tax (I-T) Act. This, they
Most policyholders still have to file claim settlement process. said, would provide fresh impetus to
reimbursement request as cashless A few even faced tough times due to people to buy a comprehensive health
continues to be a small proportion of inefficient processes of hospitals and cover.
the overall claims. Around 68% of the insurers. The report also found that
claims are reimbursement and only around 19% respondents had to wait They have also sought tax benefit to
32% are cashless, according to a report 24 hours to get their claims settled those opting for home insurance under
titled India Health Insurance XP Survey when they opted for cashless and 46% 80C of the I-T Act. Under Section 80D,
2020 by Beshak, a research platform had to wait for seven to 24 hours. Of one can get tax deduction of up to Rs
for insurance users. those who opted for reimbursement 25,000 for health insurance premiums
One reason for this is that policyholders claims, 29% had to wait for over eight for individuals below 60 years, and up
to Rs 50,000 for individuals above 60
didn't go to a hospital which was part of weeks for the settlement and 33% had years. One can claim tax deduction of
the insurer network. "There are other to wait for four to eight weeks.
The Insurance Times, February 2021