Page 13 - Insurance Times December 2020

Health Insurance

57% of COVID-19 claim re- policies and claims amount because of pendency Unit (HDU) hospitalisation

mains unsettled the slow settlement in some large after being diagnosed with Covid-19.
The CI benefit is 40% of sum insured.
ticket COVID-19 claims.
The data compiled by the General In- Insurance companies allege that hos- Commenting on the product launch,
surance Council shows that general pitals have been discriminatingly over- Subhrajit Mukhopadhyay, Executive
insurers are yet to settle and payout charging patients who have a health Director, Edelweiss Tokio Life Insurance
57 percent of the COVID-19 claim insurance cover and hence insurers said, "We have always strived to cre-
amount.
and looking into the details of these ate relevant innovation, in line with the
According to the data, general insur- large claims. changing customer needs. Through our
ance companies across India received General insurance companies have al- recent customer interactions, we
a total of 5,53,188 policies for claims ready made provisions for these realised that the threat of financial
under COVID-19. Out of this, insurance COVID-19 claims and now the payout impact has made this disease even
companies have settled 3,92,718 poli- will reflect in their cash flows. more daunting. People are worried
cies which keep around 29 percent of that a Covid-19 diagnosis will disrupt
policies outstanding and pending for Edelweiss Tokio Life Insur- their savings and therefore their long-
settlement. ance launches 'Covid term aspirations. We want to take
The number of outstanding policies away that worry from our customers
may not look very big only till one finds Shield + through Covid Shield+ and let them

out the amount of the pending claims A coronavirus-focused health insurance focus on a healthy recovery instead of
behind these outstanding policies. The plan called 'Covid Shield +' was their finances."
data further reveals that general insur- launched by Edelweiss Tokio Life Insur- The enhanced sum insured which can
ers are yet to pay out around Rs 4,776 ance recently. range from Rs 20-25 lakh gets trig-
crore or 57 percent of the total Rs It combines a critical illness benefits gered once the insured person is diag-
8,444 crore worth of claims and this is and a term cover. The plan has a small nosed with Covid-19.
estimated to be the amount behind base of 1.25 times the premium. The If the insured person dies of Covid-19
the 29 percent pending policies wait- plan is activated after a one-time pay- during the policy tenure, the term
ing to be settled. ment of premium and carries 1-year cover is paid to the family.
If one looks at the top five states as per tenure. "There were several factors that con-
COVID-19 claims, unsettled policies lie It is a single-disease cover that com- tributed to this product design. While
anywhere between 27-34 percent bines critical illness benefits and term ICU/HDU hospitalisation can be an ex-
whereas unsettled/pending claims cover. For a minimum premium of Rs pensive affair, the peripheral and post-
amount is between 56-60 percent. 5,329, the plan offers critical illness hospitalisation costs for recovery are

According to industry sources, there is benefits of Rs 10 lakh 24 hours post also significant. There is also a consid-
a widening lag between the unsettled Intensive Care Unit (ICU) or High-de- erable risk of income loss if the bread-

The Insurance Times, December 2020