Insurance policy coverage: Irdai pushes insurers harder to cover disability, mental illness and HIV | Business News in India

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BENGALURU: More than a year after India amended its insurance coverage laws to include people with disabilities, mental health issues and HIV, IRDAI found that many insurance companies did not still have no specific policies for such coverage. So the insurance regulator in a circular on Wednesday ordered insurers to disclose their underwriting policy – in an effort to ensure all general health policies cover disability, HIV and mental health issues.
So far, only public health insurance plans partially cover some of these conditions. Niramaya’s health insurance plan covers conditions resulting from disability, mental retardation, cerebral palsy, autism and multiple disabilities. Ayushman Bharat, which started after the regulatory change, offers 17 packages for mental health disorders, which also include substance use and cover ECT, rTMS, MRI scans, and most blood tests. Ayushman Bharat, however, does not cover HIV although there are ongoing discussions to expand coverage for this condition.
Regarding public health insurance schemes such as TN CM Comprehensive Health Insurance Scheme or Mahatma Jyotiba Phule Jan Arogya Yojana of Maharashtra – in effect for 8-10 years – coverage still has not started for these conditions.
And in the area of ​​private non-government health insurance, very few insurance companies offer coverage. For patients with HIV or AIDS, one of the few policies that offer coverage is Star Health Insurance’s India Medi-Classic Insurance Plan. Regarding disability, Star Health offers a compensation-focused health insurance policy for children and young adults (ages 3 to 25) with autism.
Noting the large coverage gap, IRDAI said that “every insurer should develop a health insurance underwriting policy covering … not only normal lives but also substandard lives. Control Act 2017 and Mental Health Act 2017. “Both of these laws were amended in 2019 to require insurers to provide health insurance to vulnerable populations.
“While insurance companies have stopped using exclusion coverage for people with mental illness, disability and HIV, they have not actively started to cover. Most insurers have simply removed those words off their exclusion list and stuck there, “said an insurance official at a public sector insurance company.
Insurers say it won’t be easy to cover these populations as their inclusion could dramatically increase claims; resulting in the need for higher pricing of insurance policies for all policyholders. “It will be a challenge to comply with IRDAI guidelines,” said a managing director of an insurance company.


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