As India went under lockdown in the fourth week of March to slow the spread of the novel coronavirus, and hospitals shut their doors to all treatments bar emergencies, insurance claims for hospitalisations also went down.
Six general insurance companies that The Indian Express spoke to have reported a 40 per cent-70 per cent fall in hospitalisation claims during April-May.
This reflects the trend of non-Covid patients staying away from hospitals or deferring non-emergency planned surgeries, as well as the sharp decline in road accident cases during the lockdown.
However, a rush of non-Covid claims is anticipated soon from patients who can no longer postpone their treatment, even as the numbers of Covid-19 cases continue to rise.
Bisheshwari Singh, Chief Marketing Officer, Universal Sompo General Insurance Co, said non-Covid claims declined 40 per cent-45 per cent during April and May.
“The majority of claims reported during this period were under emergency hospitalisation related to the circulatory system, the genitourinary system, chronic renal failure, maternity-childbirth, and cancer.”
Bhaskar Nerurkar, head of health claims at Bajaj Allianz General Insurance, said: “Immediately after the lockdown, in the last week of March and first week of April, cashless claims came down to around 33 per cent – down by 67 per cent – as compared to normal times.”
An internal analysis by the company showed that the sharp decline was on account of “deferment of planned surgeries, decline in accidental injuries during lockdown, and sharp reduction in digestive infections as people have not been going and eating out,” Nerurkar added.
Universal Sompo’s Singh said claims related to common conditions like digestive and infectious disease have sharply reduced.
Also, he said, accidental claims dropped by 70 per cent due to complete lockdown in April and May.
A senior official at Iffco Tokio General Insurance said claims received during April and May were 60-70 per cent lower than in these months last year.
An official of a private insurance company who declined to be quoted said, “Many hospitals, even big ones, are refusing to take in normal (non-Covid) patients, especially in big cities like Mumbai. Many of them are covered by health insurance.”
A senior official with a public sector insurance company said the decline in claim numbers in April and May has impacted public insurers as well.
“There has been a fall in non-Covid claims in the last two months,” this official said. “Hospitals are telling patients to postpone non-essential non-Covid treatments. The government wants Covid treatment to be done on a priority basis.”
Industry insiders said that with the focus almost entirely on Covid, and several hospitals converted into Covid care and treatment centres, patients with serious non-Covid conditions had suffered. The fear of contracting the virus had also kept many of these patients away from hospitals in general.
“Also, many were turned away by hospitals that had started to focus primarily on Covid treatment,” a senior official with a general insurance company said.
This official expressed concern that “millions of non-Covid patients who are critical were not, in many cases, getting the best possible timely treatment because of the pandemic”.
Insurers, however, feel that as the government moves towards lifting the lockdown entirely, there may be a jump not only in the numbers of claims, but also in the claim costs.
Already, said Nerurkar of Bajaj Allianz, “We have seen a rise in claim numbers over the last couple of weeks, and it has reached around 70 per cent of our regular claims.”
He expected “a surge in claim numbers post the lockdown and an overall increase in claims cost by 15-20 per cent”, Nerurkar said. “That is because hospitals are doing Covid tests even for non-Covid patients. While their argument is that it is for the safety of the health workers, this adds to our costs as all tests done during hospitalisation are covered,” he said.
Universal Sompo’s Singh said that patients had put off most non-essential surgeries for fear of infection, but once the lockdown is lifted, “we anticipate an increase in the number of claims in the coming months from these patients who had postponed treatments.”
📣 The Indian Express is now on Telegram. Click here to join our channel (@indianexpress) and stay updated with the latest headlines