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Health Insurers Witnessing Record Number of Claims Amid Coronavirus

Published On Aug 28, 2020, Updated On Apr 20, 2021

As the cases of Coronavirus (Covid-19) are rising steadily across the nation, the number of positive coronavirus cases has crossed the figure of 33 lakh ending August 2020. During this pandemic, the number of health insurance claims has also climbed higher than ever that has made general insurance companies, including standalone health insurance providers, to receive a record number of claims with more than three times of claim requests in less than a month's time. This is unprecedented data for the insurance industry which is hitting them harder than ever. 

The number of claims reported by the policyholders on account of different treatment expenses was around 11,405 of Rs. 178 crore on June 8, 2020, from which around 6,495 claims worth Rs. 58 crore got completely settled by the insurance companies. While this number soared more than 3 times to reach  34,264 reported claims worth Rs. 562 crore on July 3, 2020, out of which 22,998 claims got settled of Rs. 184.9 crore, as per the data of the General Insurance Council. 

Talking about the state-wise claims in India, Maharashtra tops the chart by alone reporting 15,753 claims of Rs. 195 crore. The state is followed by Delhi, the most severely affected city, which reported 5,909 claims worth Rs. 134 crore. However, in addition to these, the list goes on with the Tamil Nadu, Karnataka, Haryana and West Bengal, in relation to the highest number of claims. However, the average amount of claims reported have increased from Rs. 1.56 lakh in June to Rs. 1.64 lakh in July, but the settled claim amount got reduced from Rs. 90,118 to Rs. 80,427. 

The gap between the claims requested and claims settled was majorly due to the discrepancy between the coverage scope of different health insurance plans and treatment costs charged by different hospitals. However, as per the industry experts, the amount of settled claims could even touch “thousands of crores” if the soaring new cases do not witness a fall in the coming months, which is when only 4% of the population in India acquires any type of medical coverage. 

The insurance providers are also predicting a further surge in a claim due to the guideline issued by the Insurance Regulatory and Development Authority of India (IRDAI) as per which all the insurers were directed to come up with their Covid-19 specific insurance products by July 10, 2020. However, many insurers are worried about the uncertain trajectory of the rising cases and still factoring the price of the products considering the present and predicted surge in claims, due to which they are yet to file their health insurance products before IRDAI. 

You May Also Like To Read: Covid-19 Health Insurance Policies

Disclaimer: This article is issued in the general public interest and meant for general information purposes only. Readers are advised not to rely on the contents of the article as conclusive in nature and should research further or consult an expert in this regard.


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