Why autistic kids need a ‘special’ health cover

As child-centric disorders like autism get diagnosed more often, insurance companies are looking to provide standalone products or add-ons to existing ones.

Currently, not many insurers have children-specific offerings, but the segment is expected to grow with the anticipated rise in demand for specialised health insurance products.

According to Mukesh Kumar, Executive Director, HDFC Ergo General Insurance, treatment for medical conditions such as autism are not defined under health insurance plans. They, therefore, get excluded from policies. “The segment is anticipated to shape up as the demand for specialised health insurance products rise,” he told BusinessLine.

Autism on the rise?

According to Dr Ashok Mittal, director of paediatrics & neonatology, Medica Superspecialty Hospital, it is difficult to ascertain whether instances of autism are on the rise or if the diagnosis of cases has gone up.

“Globally, one in 68 children is detected with autism spectrum disorder (ASD),” Mittal said. ASD brings with it a group of developmental problems, jeopardising a child’s speech, gestural, non-verbal and social interaction with his peers.

 

Coverage

According to industry experts, since health insurance products for children in India are yet to take off on a large scale, children with autism and other mental diseases are generally declined (health) cover.

An autistic child requires multi-disciplinary treatment, including the intervention of psychiatrist, counsellors, special educators, speech and occupational therapists, apart from a paediatrician. The annual medical expenses could be Rs. 2-3 lakh, Mittal said.

Star Health and Allied Insurance offers customised group medical cover for people with autism and is in the process of developing a dedicated product.

“The requirement of people with autism is specialised and multi-disciplinary. Coverages under a regular policy may be insufficient. Hence, there is a need for development of a dedicated product,” Anand Roy, Executive Director and CMO, Star Health Insurance, said.

According to Sanjay Datta, Chief – Underwriting and Claims, ICICI Lombard General Insurance, it needs to be seen if there are enough number of people with autism to make the product viable.

“There could be a customised offering dealing with autism in the existing health insurance product (instead of a standalone product, which may not be viable),” he said.