NEW DELHI: Ratish Arora, an executive with an advertising firm, had opted to pick up a COVID-19 insurance cover for his family after the outbreak of the pandemic. And unfortunately, his fears came true his wife and parents were infected with COVID-19 in December. However, despite many mails and verbal requests, his claim is yet to be settled by the insurance company.
"I wrote several mails, but the insurance company is yet to settle them. I have sent all the bills, but first they drastically cut down the amount and after all the documentation, they are just buying time on one pretext or another. After I took up the complaint with higher authorities, they are now processing my case," Ratish said.
This is not an isolated case despite charging hefty amounts for health premium during the pandemic, health insurance companies have settled only 54 per cent of COVID claims, leaving 1.41 lakh claims pending.
According to figures available with the General Insurance Council, as of March 31, a total of 9,96,804 people made claims for COVID. However, insurance companies have only settled the claims of 8,55,250 people, leaving out 1,41,554.
In terms of value, claims worth Rs 14,680 crore have been made. However, as of March 31, only claims worth Rs 7,900 crore had been settled just 54 per cent of the total amount claimed by the insured. The figuresa also suggest that in the last 11 months up to March 1, insurance firms reported a 13 per cent increase in health insurance premium income to Rs 52,886 crore.
Not only is the delay in settlements stressful for the insured, it is also not in line with what the insurance regulator Irdai had advised all general and health insurers - to decide on the settlement of health claims pertaining to Covid-19 within two hours.
The numbers are not flattering, especially when there has been a resurgence in COVID cases. It isn't just private insurance companies either. Many state-run insurers are also delaying payments, much to the dismay of consumers. With complaints rising, the IRDAI has come down heavily and has asked insurers to settle claims as soon as possible.
Just five states make up 66 per cent of all COVID claims
About two thirds (66.37 per cent), of total claims made under Covid health insurance policies are from just five states Maharashtra, Gujarat, Karnataka, Tamil Nadu and Delhi worth Rs 9,744 crore. Maharashtra has the maximum number of COVID-19 related insurance claims, with 3.58 lakh claims for Rs 4,345.39 crore