Why autis­tic kids need a ‘spe­cial’ health cover

In ris­ing num­bers, due to bet­ter di­ag­no­sis, in­sur­ers see an un­met need

The Hindu Business Line - - FRONT PAGE - SHOBHA ROY

As child-cen­tric dis­or­ders like autism get di­ag­nosed more of­ten, in­sur­ance com­pa­nies are look­ing to pro­vide stand­alone prod­ucts or add-ons to ex­ist­ing ones.

Cur­rently, not many in­sur­ers have chil­dren-spe­cific of­fer­ings, but the seg­ment is ex­pected to grow with the an­tic­i­pated rise in de­mand for spe­cialised health in­sur­ance prod­ucts.

Ac­cord­ing to Mukesh Kumar, Ex­ec­u­tive Di­rec­tor, HDFC Ergo Gen­eral In­sur­ance, treat­ment for med­i­cal con­di­tions such as autism are not de­fined un­der health in­sur­ance plans. They, there­fore, get ex­cluded from poli­cies. “The seg­ment is an­tic­i­pated to shape up as the de­mand for spe­cialised health in­sur­ance prod­ucts rise,” he told Busi­nessLine.

Autism on the rise?

Ac­cord­ing to Dr Ashok Mit­tal, di­rec­tor of pae­di­atrics & neona­tol­ogy, Med­ica Su­per­spe­cialty Hos­pi­tal, it is dif­fi­cult to as­cer­tain whether in­stances of autism are on the rise or if the di­ag­no­sis of cases has gone up.

“Glob­ally, one in 68 chil­dren is de­tected with autism spec­trum dis­or­der (ASD),” Mit­tal said. ASD brings with it a group of de­vel­op­men­tal prob­lems, jeop­ar­dis­ing a child’s speech, ges­tu­ral, non­ver­bal and so­cial in­ter­ac­tion with his peers.


Ac­cord­ing to in­dus­try ex­perts, since health in­sur­ance prod­ucts for chil­dren in In­dia are yet to take off on a large scale, chil­dren with autism and other men­tal dis­eases are gen­er­ally de­clined (health) cover.

An autis­tic child re­quires multi-dis­ci­plinary treat­ment, in­clud­ing the in­ter­ven­tion of psy­chi­a­trist, coun­sel­lors, spe­cial ed­u­ca­tors, speech and oc­cu­pa­tional ther­a­pists, apart from a pae­di­a­tri­cian. The an­nual med­i­cal ex­penses could be ₹2-3 lakh, Mit­tal said.

Star Health and Al­lied In­sur­ance of­fers cus­tomised group med­i­cal cover for peo­ple with autism and is in the process of de­vel­op­ing a ded­i­cated prod­uct.

“The re­quire­ment of peo­ple with autism is spe­cialised and multi-dis­ci­plinary. Cover­ages un­der a reg­u­lar pol­icy may be in­suf­fi­cient. Hence, there is a need for de­vel­op­ment of a ded­i­cated prod­uct,” Anand Roy, Ex­ec­u­tive Di­rec­tor and CMO, Star Health In­sur­ance, said.

Ac­cord­ing to Sanjay Datta, Chief - Un­der­writ­ing and Claims, ICICI Lom­bard Gen­eral In­sur­ance, it needs to be seen if there are enough num­ber of peo­ple with autism to make the prod­uct vi­able.

“There could be a cus­tomised of­fer­ing deal­ing with autism in the ex­ist­ing health in­sur­ance prod­uct (in­stead of a stand­alone prod­uct, which may not be vi­able),” he said.

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