December 8, 2023


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‘Health insurance firms refusing cover to Covid-recovered patients’

New Delhi: At a time when the country is reeling under a health crisis triggered by the Covid-19 virus, many health insurance companies are denying people health insurance if they have been infected with Covid-19.

Major health insurance companies have quietly decided to refuse health insurance to individuals who have been affected with Covid-19, citing that the companies are at risk to enrol them for the first few months of their recovery since they have reports of many patients showing cases of symptom relapses and hospitalisation for Covid-19 recovered patients in the first three months.

Most of these health insurance companies have framed policies of a “cooling off” period of 45 to 180 days for Covid-19 recovered patients before they are issued any health insurance policies.

Many people reached out to The Sunday Guardian expressing their anguish over the “arbitrary” policy which deprives people of something which is “as basic as health insurance”.

Manisha Singh, a home maker in New Delhi, told The Sunday Guardian that she was looking to purchase health insurance for her two children who just recovered from Covid-19, but all the major companies turned her away saying that her children had to wait for at least 45 days.

“We have seen what happened during the second wave of Covid-19 in Delhi; people who did not have insurance were being ripped off by hospitals. Understanding the importance of health insurance, I decided to enrol both my children who just recovered from Covid-19, but all the insurance companies that we reached out to said that they couldn’t issue us any insurance for 60 days since my children were Covid-19 positive around 20 days ago. Is this not unfair and arbitrary? I urge the government to intervene in this matter,” Manisha said.

A businessman from Delhi, who had to be hospitalised for Covid-19 and has recovered, was allegedly told by the Max Bupa health insurance company that he had to wait for at least 120 days before he could be issued a health insurance by Max Bupa, while ICICI Lombard health insurance company told him that he had to wait for 90 days before he could be issued a policy since he  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.