COVID medical insurance claims on the lower side

Only 5.3% of all persons testing positive sought it; similar pattern seen in death cases

Medical insurance claims for COVID-19 patients accounted for just 5.3% of all the persons testing positive in Karnataka while claims for dead accounted for 7.3% of total COVID-19 deaths in the State.

Out of the total 26,04,431 positive cases reported in Karnataka till May 31, a total of 1,40,198 insurance claims, accounting for 5.3 per cent, had been made. Medical insurance is extended to COVID-19 patients under hospitalisation as well as home isolation.

Similarly, 2,150 insurance claims had been made for the persons dying of COVID-19 in the State so far while a total of 29,090 deaths had been reported till May end. The insurance claims for dead accounted for 7.3% of all COVID-19 deaths in the State.

According to data made available by General Insurance Council of India to Project Jeevan Raksha, a public-private initiative to analyse COVID-19 trends across the country, the percentage of insurance claims for hospitalisation and home isolation against total COVID-19 patients as well as claims for the dead against total COVID-19 deaths were marginally lower in Karnataka than across India.

Though the number of claims dipped from 5,504 in January this year to 1,053 in February, it rose to 4,302 during March before reaching 6,679 during April and catapulting to a whopping 57,581 during May, the month that witnessed COVID-19 peak in the State.

Mysore Sanjeev, convenor of Project Jeevan Raksha, said there had been a decline in the percentage of insurance claims against total cases in the State from March this year – from 8% in March to 5% in April and May. Even though the number of claims increased, their percentage against total cases came down.

Financial burden

“This trend indicates there is a possibility of private hospitals insisting on direct payment for treatment and also an increase in the number of uninsured patients undergoing treatment,” said Mr. Sanjeev, adding that the financial implication of undergoing COVID-19 treatment in private hospitals was forcing lower and middle income families to avoid hospitalisation in the early and moderate stage of infection, thus exposing themselves to higher risk.

The financial burden arising out of COVID-19 treatment in private hospitals may be contributing to the higher mortality in Karnataka, especially in semi-urban and rural areas..

Citing data available with the National Statistical Office functioning under the Union Ministry of Statistics and Programme Implementation, Mr. Sanjeev said more than 80% of the country’s population or more than 108 crore people in India have no option but to fund their hospitalisation expenses from their savings, which are otherwise kept for their retirement, children’s education or children’s marriage. Barely 13 per cent of the country’s citizens are covered under government-sponsored health insurance schemes, he added.

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