Despite case surge, insurance claims at just 40% of peak, Health News, ET HealthWorld

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Kolkata: Despite case surge, insurance claims at just 40% of peakKolkata: Covid cases in Kolkata and the rest of Bengal may have crossed last year’s peak figure, but health insurance claims have been significantly lower than the highest applications made in July, August and September during the first wave.

The insurance claims for Covid treatment in hospitals in the first 10 days of April have touched 30%-40% of last-year’s peak application figures. In March, it was 10%-15%.

Despite the substantial rise in Covid cases in the first 10 days of April, insurance claims had not increased proportionately, experts said. They felt the reasons could be home quarantine and admission to government hospitals. In private hospitals, which had also been witnessing a surge in cases in April, the number of critical cases had been fewer, experts said. Most claims, said insurers and third party administrators, were from Maharashtra and Gujarat.

Jyotirmoy Kundu, network manager of Heritage TPA, said a lot of Covid patients were getting admitted to government facilities. “There has been a significant jump in Covid numbers in the past five-six days, but the number of insurance claims has been 30%-40% of the peak application figures,” he said, adding they were receiving intimations from patients in government facilities as well. Echoing him, Chiranjib Bera of Raksha TPA said insurance applications jumped in the past week but it was still 40% of the highest applications last year. “A lot of people are opting for home quarantine, and so, the claims are still limited. We do not know what will happen after 15 days but as of now it is lower than the peak,” he added.

Sophia Singh, GM (health) of National Insurance, pointed out Bengal saw a rise in claims compared to that in December-January-February. “Most applications are from Maharastra,” she added. According to her, the sale of Corona Kavach policy, which increased the most in December, is coming down. Sanjay Datta, chief-underwriting, claims and reinsurance, ICICI Lombard General Insurance, agreed: “There is no major inflow of claims from Bengal, unlike from Maharashtra. Vaccination will play a crucial role in reducing the impact of the second wave,” he said. Going by cashless intimations, Dutta added there were 70 in December last year, but 23 till March 29 this year.

Even Bhaskar Nerurkar, head health claims of Bajaj Allianz General Insurance, said after mid-February, there was a 50% jump in insurance claims though most were in western parts. “The Kolkata number has so far been the least among metros,” he said, adding the average ticket size of claims for Covid had gone down by 5%. But Prasun Sikdar MD & CEO ManipalCigna Health Insurance Co, said case rise had pushed up claims as well as demand for health cover

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