Page 40 - Insurance Times February 2024

Government Group Insurance Individual Total lives
sponsered business business business covered
(In crores) (In crores) (In crores) (In crores)
Number of lives 30.6508 16.2288 5.1623 52.0419
% of total lives covered 58.89% 31.18% 9.9% 100%
by any insurance
As a % of total Indian 21.63% 11.44% 3.64% 36.72%
population (141.7 crore
in March 2022)

Source : IRDA report 2021-2022

With this low government spending and 63% of the to be covered by means of a separate critical illness policy
population having no health insurance, access to proper and or a critical illness rider, or a specific cancer insurance policy.
timely healthcare in case of major health episodes like cancer
is limited. Those who are insured under the basic Citical Illness policies / Cancer Insurance
hospitalization indemnity product are also underinsured, as
the cost of treatment for cancers is quite higher than the Policies in India
average sum assured under health insurance policies. The Generally critical illness policies issued in our country provide
patients (households) thus have to meet this high cost of coverage for two or more of the following critical diseases.
cancer treatment out of pocket which is impoverishing many The majority of these plans provide cover for cancer as one
families every year. It is not uncommon in India to even raise of the Critical illness.
medical loans and go for crowd funding for treatment these Cancer of specified severity
days. Myocardial infarction (first heart attack of specific
severity
A basic health insurance policy covers only the actual
medical, surgical, and hospitalization expenses incurred by Open chest CABG
the insured. They further have sub-limits on the various Open heart replacement or repair of heart valves
expenses like room rent, ICU charges, etc. incurred by the Coma of specified severity
insured. These kinds of policies take care of the expenses Kidney failure requiring regular dialysis
associated with hospitalization, medication, and treatment
Stroke resulting in permanent symptoms
of minor illnesses. Dreaded diseases like cancer, heart
attack, coma, or major organ failure are associated with Major organ /bone marrow transplant
extremely high costs of healthcare which include a Permanent paralysis of limbs
substantial component that may not be covered under the Motor neuron disease with permanent symptoms
hospitalization indemnity products. This could be due cost Multiple sclerosis with persisting symptoms
of treatment exceeding the sum insured, or there could be
high outpatient (ambulatory) expenditure not covered under Angioplasty
hospitalization insurance. Benign brain tumor
Blindness
There could also be a need for additional expenses like long-
Deafness
term nursing care or home-based nursing, and loss of income
of the patient and caregivers. Such expenses are financially End-stage lung failure
devastating to the household where such an episode occurs. End-stage liver failure
Frequent research and innovations in cancer treatment can Loss of speech
significantly cure and improve the quality of life of cancer
Loss of limbs
patients but the moot question is how many patients are
Major head trauma
able to avail these advanced treatments with the huge cost
involved? Since treatment of critical illness like cancer Primary (idiopathic) pulmonary hypertension
treatment requires much more extensive coverage, it needs Third-degree burns

The Insurance Times February 2024 37