Health insurance companies get over 900K Covid-19 claims, settle 84%

Health insurance companies are seeing the number of Covid-19-related claims rising, even as the pace of growth has slowed since the August-December period.
 
As of February 25, general and standalone health insu­r­ers have received 908,849 Covid-related claims, amounting to Rs 13,752.41 crore, according to the data compiled by General Insurance Council, which is not publicly available.
 
They have settled 761,676 claims, amounting to Rs 7,141.33 crore, almost 15 per cent of the health premiums the insurers have collected till January.
 
Overall, the insurers have settled almost 84 per cent of the claims in terms of the number of claims, and 52 per cent in terms of the amount of claims.
 
At the end of July, only 81,000 Covid-19 claims were filed with insurers. That number doubled in a month’s time to 160,000, and breached 475,000 by October-end. By mid-November, the figure had surpassed 576,000, reaching 664,488 by early December amounting to Rs 9,989.89 crore.
 
The average Covid claim received by the insurers is around Rs 1.51 lakh, but the average claim settled by is Rs 93,758.17.
 
“While the number of cases have dropped tremendously, the claims did not follow the same trajectory because a fair bit of our claims come in the form of reimbursement too,” said Bhabatosh Mishra, Director Underwriting, Prod­u­cts & Claims, Max Bupa Health Insurance.

 
“And, now we are seeing more reimbursement claims coming in compared to new cashless claims,” he added.
 
This is one of the reasons why there is gap in the number of claims reported and the number of claims settled by the insurers so far.  Going forward, insurers are unsure about the trajectory of claims because while the cases have seen an upward trend in some states, the government has also started the vaccination drive. Also, the impact of the huge Covid claims burden on the loss ratio is something the insurers are still evaluating. While on the one hand there have been huge Covid claims, some of the avoidable claims such as accident claims were far less than normal as there was a stringent lockdown in place for most part of the year.
 
Even the planned treatment claims were far less than normal, but these are slowly rising now, experts said.
 
“For many insurance companies, the claim ratio is possibly a little higher than what they had planned for,” Mishra said.