is a segment that has seen launch of several niche insurance
covers. However, there are still a lot of areas in health and medical illnesses which are excluded from the ambit of insurance.
Here are some of the ailments
which are currently not covered in India.
Caused by the HIV virus that is communicable through blood transfusion, infected syringes or contact with body fluids of the infected person, no concrete medicine has been discovered to completely cure a person. Though insurers say that it is not fatal if discovered in the initial stages, these individuals are considered high-risk and are not offered insurance
for life or health
Not able to conceive a child among women is an area which is not covered by insurance.
This involves several rounds of treatment for investigating the causes and also involves manual injections and in-vitro fertilization (IVF); procedures which are considered risky to be covered by insurance.
Though these treatments are costly, they are not covered.
Medical conditions related to genetic
issues are excluded from health insurance
since they are considered as high-risk pre-existing medical conditions. These may include some forms of anaemia, thalassemia and Down's Syndrome among others.
Tobacco use and related complications:
While each individual is asked to disclose their tobacco
usage to determine their insurance
premium, those addicted to tobacco
and having signs of associated ailments
like throat cancer
are not covered. Even if somebody fails to disclose their tobacco
usage and later claims for a related ailment, their claim is rejected.
Advanced stages of cancer:
policies are available in the market and are available for people to purchase to act as a buffer if they contract cancer
in the future. But those who already have cancer
or are in the advanced stages of cancer
are not offered health insurance
policies, since there is an imminent risk of high claims and threat of anti-selection. Anti-selection occurs when an individual aware of their ailments
take a medical policy
and takes it on favourable terms than what would have been offered if they had disclosed their conditions.
works on the principle of pooling where the pooled premium
from all policyholders is used to pay claims, insurers wish to avoid those customers with a morbid condition who would claim higher and would impact the claim payments to otherwise healthy customers.