Swine flu will be covered under all mediclaim policies

Mumbai: Existing comprehensive health insurance policies will also cover hospitalisation expenses of patients affected by swine flu, insurance company officials said.
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Some insurers have already received claims for hospital expenses, though the number is not very large. However, given the fact more people are being hospitalised, insurance companies expect the number of claims to go up in the future.

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"Hospitalisation expenses of swine flu patients will be covered under the existing comprehensive health insurance policies of the insurance companies. There is no upper limit on the expenses. The customers can avail themselves of the amount commensurate to the sum assured," said an Oriental Insurance company official.

The hospitalisation charges will be borne by the insurance company subject to the cap on the room rent charges, a New India Assurance Company official said.

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Few claims so far

Swine flu will be covered under all the health insurance and travel insurance policies offered. A few claims have been received but the number is not large, said Sanjay Datta, Head Health Vertical, ICICI Lombard General Insurance Company.

Insurance companies are also expecting claims in the health segment to go up, but not by much.

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The claims in this segment will go up as the number of instances of hospitalisation increases. However, the outbreak is in the initial stages and the number of people who have taken a health insurance policy is also very low. Also, a very small proportion of people who have been diagnosed with the flu have to be hospitalised, Datta said.

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"At this point in time, the incidences of swine flu have not reached any threshold to have a significant impact on the number of claims logged. However, we have robust IT infrastructure and comprehensive network of providers to counter any exigencies that may arise in the near future," said the spokesperson of Apollo DKV, a standalone health insurance company.

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Most of the general insurance companies are operating through Third Party Administrators to settle claims.

Currently, more people are getting themselves tested for the flu rather than being hospitalised. Since the Government is bearing all the costs for the detection tests, the insurance companies are not burdened with that cost. Also, very few insurers offer policies covering OPD expenses, said a TPA official.

Some of the insurers such as ICICI Lombard and Apollo DKV also offer health insurance policies that cover the OPD expenses.