Health insurance claims stay stable

With the third wave of the pandemic proving to be less severe than the first two, there has not been a significant rise in health insurance claims for the general insurance sector which had seen a deluge of claims after the second wave.

“There have not been too many cases of hospitalisation in the current cycle of Covid-19. Hospitalisation was only in cases where the patient had some other complication; most patients managed under home isolation this time,” said Bhaskar Nerukar, Head – Health Claims, Bajaj Allianz General Insurance.

At present, Covid-related claims for the insurer are at just 8 per cent of the claims it received in the second wave of the pandemic.

“As the infection is milder, the Covid-related claim size also came down by 17-18 per cent while the duration of hospital stay is also lesser. Even in

terms of home isolation, just 10 per cent of the overall Covid-19 claims are for home isolation this time, compared to 25 per cent at the peak of the second wave,” Nerurkar said.

However, this time around too, claims for other hospitalisations have come down as people may be postponing elective and non-urgent procedures. These claims have come down by almost nine per cent, he added.

According to Satish Gidugu, CEO and Whole Time Director, MediAssist Healthcare Services, Covid-related claims had begun to stabilise in the October to December 2021 quarter and amounted to just three to four per cent of the total claims compared to a peak of 70 to 80 per cent in the second wave.

“In the third wave, we do see volumes with about 11 per cent to 12 per cent of our claims coming from Covid but there is much lesser severity, and there isn’t a crisis situation as seen in the second wave,” he said.

Both the duration of stay and average claim amount were lower in the third wave for the hospitalisation cases facilitated by MediAssist.

In January 2022, the average claim size for a Covid-related hospitalisation was Rs. 93,000 and the duration of stay was six days, according to MediAssist for its cases