Irdai wants health covers to include alternative treatment methods
Insurance companies are increasingly providing cover for Ayush (ayurveda, siddha, unani and homoeopathy) treatments in their policies. However, utilisation of the cover still remains negligible. The Insurance Regulatory and Development Authority (Irdai) too wants inclusion of these alternative treatment methods in health covers.
“Irdai had sent communication to insurers on including Ayush as part of the health cover. But the regulator has not made it mandatory. Most of the insurance companies are now providing cover to such treatment,” said Suresh Sugathan, head, heath insurance, Bajaj Allianz General Insurance.
Bajaj Allianz General Insurance had launched Healthcare Supreme last year, which covers Ayush treatments. Ayush has been part of some of the group medical policies offered by the company. Apollo Munich’s Family Floater plan too provides a cover of up to Rs 20,000 for Ayush treatment. Star Health and Allied Insurance has several policies, which cover Ayush treatments. It has put a cap of 25 per cent of the sum insured for such treatments. But, Star Health has seen utilisation of approximately two per cent. In case of Bajaj Allianz also the claim made for Ayush treatments is just two to three per cent.
Most of insurers provide cover only for hospitalisation and largely Ayush treatments do not require hospitalisation as in the case of modern medicine. In case of Bajaj Allianz, it only covers in-patient expenses in a government hospital. The number of government-run Ayush hospitals is limited and those providing in-patient facilities are fewer.
“We insist only on treatment by a licenced practitioner. All the expenses, including consultation charges as part of the hospitalisation is covered,” said D Rama, assistant vice-president, product cell, Star Health Insurance.
For insurance companies, lack of standardised treatment protocol and cost structure remain big deterrents. “Alternative medicines need regularisation of treatment protocol and the cost also varies from practitioner to practitioner. We have in-house team to verify the treatment and cost,” said Sugathan.
“The chances of abuse are higher as there is no specific treatment protocol. Treatment for the same ailment can cost Rs 5000 and Rs 50,000 depending upon the practitioner,” added Rama. Insurance companies want healthcare providers to make efforts to standardise protocols and cost. They also hope that these are early days and gradually the utilisation rates would go up
source
“Irdai had sent communication to insurers on including Ayush as part of the health cover. But the regulator has not made it mandatory. Most of the insurance companies are now providing cover to such treatment,” said Suresh Sugathan, head, heath insurance, Bajaj Allianz General Insurance.
Bajaj Allianz General Insurance had launched Healthcare Supreme last year, which covers Ayush treatments. Ayush has been part of some of the group medical policies offered by the company. Apollo Munich’s Family Floater plan too provides a cover of up to Rs 20,000 for Ayush treatment. Star Health and Allied Insurance has several policies, which cover Ayush treatments. It has put a cap of 25 per cent of the sum insured for such treatments. But, Star Health has seen utilisation of approximately two per cent. In case of Bajaj Allianz also the claim made for Ayush treatments is just two to three per cent.
Most of insurers provide cover only for hospitalisation and largely Ayush treatments do not require hospitalisation as in the case of modern medicine. In case of Bajaj Allianz, it only covers in-patient expenses in a government hospital. The number of government-run Ayush hospitals is limited and those providing in-patient facilities are fewer.
“We insist only on treatment by a licenced practitioner. All the expenses, including consultation charges as part of the hospitalisation is covered,” said D Rama, assistant vice-president, product cell, Star Health Insurance.
For insurance companies, lack of standardised treatment protocol and cost structure remain big deterrents. “Alternative medicines need regularisation of treatment protocol and the cost also varies from practitioner to practitioner. We have in-house team to verify the treatment and cost,” said Sugathan.
“The chances of abuse are higher as there is no specific treatment protocol. Treatment for the same ailment can cost Rs 5000 and Rs 50,000 depending upon the practitioner,” added Rama. Insurance companies want healthcare providers to make efforts to standardise protocols and cost. They also hope that these are early days and gradually the utilisation rates would go up
source
Post a Comment