Health insurers see a huge surge in “Non-Covid Claims”

At the height of the second wave of the Covid-19 pandemic, as of May 2021, insurers had received 1.48 million claims in the region of Rs 22,931 crores. Of these, nearly 1.3 million were settled. By the July-September quarter, insurers witnessed a fall in the outgo of Covid-related claims. This period saw a settlement number in the region of little more than Rs 5000 crores, 35% lower than the previous quarter. In this article, we know about “Non-Covid Claims”.

Hospitals increased their rates, and this was evident from the fact that the cost per claim was up by 20-30%, although insurers had not raised their prices on their old products, putting immense pressure on the bottom line.

Recently, there has been a significant spike in non-Covid-related health insurance claims. Initially, industry watchers attributed this to the surge in planned surgeries and procedures that people had been putting off during the peak of the pandemic. Yet, as the trend continues, the industry is seeing a greater acceleration of such claims.

Industry veterans observe that though there has been a lag in capturing trends in this sector, there has been a definite uptick in non-Covid hospitalizations since September 2021.

What Are The Typical “Non-Covid Claims”?

With the onset of the winter months, several of the regular outbreaks of viruses and infections have made their appearance. The average ticket size of treatments has also increased as hospitals boost their rates. The pandemic has brought a heightened awareness of the need for health insurance. Claims are on the rise for non-Covid related conditions:

Infectious diseases: There has been a significant increase in infectious diseases such as malaria, dengue, and chikungunya post-monsoon. These illnesses may require hospitalization and lengthy treatments as the after-effects can be debilitating and often result in several other issues such as respiratory difficulties, joint pains, weakness, etc.

Surgery: Elective surgeries that were deferred during the pandemic have risen. Cataract surgery is one of the most common, with other conditions such as prostate gland surgery/procedures being opted for by patients who were afraid to avail of them earlier. Patients in India have traditionally deferred non-essential surgery till the cooler season, and perhaps this has contributed to the apparent spike in non-Covid claims during the winter season. They have realized that they cannot postpone such treatments indefinitely, as they could suffer other complications if treatments are delayed.

Treatments: Cancer treatments, dialysis, and heart disease testing and treatments have increased, as there is more awareness of co-morbidities being a risk factor in Covid complications. Patients who had postponed critical treatments at the height of the pandemic have chosen to avail of the treatment as soon as the wave seems to be ebbing. The government also advised people to avoid non-essential surgeries.

Emergencies: Emergencies have been occurring regardless of the trajectory of the pandemic and patients were receiving critical care at hospitals. Several smaller private hospitals had closed their ERs. These facilities have now re-opened, leading to an increase in claims from patients who have suffered heart attacks and strokes, been injured in accidents, etc.

Routine Check-ups: These were common in pre-pandemic hospitals, and health insurers were routinely processing such claims. However, many hospitals have re-instated these facilities in view of the crisis. This could also account for the spike in non-Covid-related claims.

Keeping these factors in mind, industry experts fear that there could be an upward revision in premium rates as the insurance sector comes under increasing pressure.

The Reason for the Huge Reduction

Some common and simple ways to stay away from Covid-19 were kept clear by the government from the beginning; these two things were considered important weapons, sanitizer, and masks. In the first period of Covid-19, people were instructed to stay at home, but in the second wave of Covid-19 people became careless and we had to pay the damages.

However, there is no doubt that the government along with the general public had become careless and we were found to see helplessness and helplessness outside the hospitals. Talk about the reason for the sharp decline in non-Covid claims for health insurers in the second and third quarters. There are many reasons for this,

Careless Attitude of the Government – During the second wave of Covid-19, the central government was busy with elections and there was a panic in the country regarding oxygen cylinders. At the same time, the general public understood that it is foolish to look at the government with hopeful eyes and the Prime Minister of the country had also clearly said that you have to protect yourself. It took a long time for the general public to understand this and by then Covid-19 had caused a lot of damage.

Beginning of Vaccination – In the month of January 2021, the vaccination was started in India with a vaccine made in India, initially, people were a little hesitant about vaccination but people did not have the option, so people slow down even if they do not want to. Come slowly. The government was also engaged in making people aware until people understood that the vaccine was necessary for them. Covid-19 knocked once again and now people are ready for vaccination due to fear of Covid-19 and not under pressure from the government.

Intensification of Vaccination – The second wave of Covid-19 worked to intensify the vaccination, on one side the public was looking for oxygen outside the hospital, while on the other hand people were now coming out of the house for the vaccine, and this fact the proof comes from photos posted by people on social media. On October 22, 2021, 100 crore Covid-19 vaccine doses had been administered in India, which proved to be a milestone in India’s Covid-19 vaccination journey. Till now the number of Covid-19 in India had also reduced to a great extent.