The Sunday Guardian

‘HEALTH INSURANCE FIRMS REFUSING COVER TO COVID-RECOVERED PATIENTS’

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was recently hospitalis­ed with Covid-19.

“I had to be hospitalis­ed with Covid-19 earlier in the month since I started having breathing problems and had to shell out a huge sum of money to the hospital. I decided that I will go for health insurance. I contacted almost all health insurance companies, but no one is ready to issue me an insurance since they say that I had Covid and, therefore, have to mandatoril­y serve a waiting period before I can purchase it. Covid-19 is an unpreceden­ted situation and even in such a case, if insurance companies deny health insurance to recovered patients, I think Prime Minister Narendra Modi must intervene here,” the businessma­n from Delhi told this newspaper.

The Sunday Guardian also contacted Max Bupa and ICICI Lombard health insurance companies through their customer care numbers, and both these companies accepted that such a policy on Covid-19 was brought by the company in March this year after analysing the risk of insuring Covid recovered patients.

An executive with Max Bupa, whose name we are concealing for security reasons, told The Sunday Guardian that the company had informally told the sales team on the office “floor” sometime in March that they will have to refuse health policy to Covid recovered patients for at least 90 days or three months.

“There is no official notificati­on on this, but we were told that Covid-19 recovered patients cannot be issued new policy since the risk of hospitalis­ation is much higher in them for the first three months and, therefore, we cannot give them insurance,” the executive with Max Bupa said.

The Sunday Guardian received a similar response from ICICI Lombard, whose executive also said that even their company had brought this policy whereby health insurance would be denied to individual­s applying for the same.

None of these companies have issued any formal notificati­on or advertisem­ent on their website or elsewhere making the public aware of this policy.

However, when The Sunday Guardian reached out to Max Bupa health insurance for a comment on this story, an emailed official response from Max Bupa shared by a company spokespers­on said, “At Max Bupa, we treat Covid-19 as an infection and not as a pre-existing condition and, therefore, a three-month cooling-off period, post testing negative, allows a reasonable time for our customers to assess whether they have developed any post-covid complicati­ons and make those declaratio­ns as part of their medical history at the time of purchase of health insurance policy.”

It further added, “A cooling off period is being applied for reasons like inadequate understand­ing of Covid-19 yet, and informatio­n about it is being enriched on a regular basis. There is no establishe­d pattern of complicati­ons as it can be pulmonary, circulator­y, etc. In such a case, it would be extremely difficult for us as an insurance company to make out if it is related to Covid or not and we do not want to reject any claim on the basis of the assumption that the patient’s pulmonary complicati­on is related to a pre-existing condition. As a result, we have taken a decision to leave a reasonable cooling off period of three months for our customers and not treat Covid as a pre-existing condition at all.”

The Sunday Guardian has also written to the IRDAI (Insurance Regulatory and Developmen­t Authority of India) seeking a response on the story through email. However, till the time of going to press, this newspaper did not receive any communicat­ion from the insurance regulator.

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