Insurance plans with specific OPD component covering mental illnesses is likely to witness a rise with the Covid-19 pandemic triggering a surge in instances of depression, anxiety and related mental health disorders.

While mental illness is currently covered as a part of the comprehensive indemnity policy, it usually covers only hospitalisation. Since a majority of the cases pertaining to mental health require counselling and therapy ― which may not necessarily entail hospitalisation ― it largely goes uncovered.

However, insurance companies are feeling the need for designing specific comprehensive cover, including the OPD component to take care of customers suffering from mental ailments.

According to Dr S Prakash, Managing Director, Star Health and Allied Insurance, there has been a surge in the number of proposals for health insurance cover from customers with mental illnesses over the past two-to-three months.

“In FY20, we had given approval to more than a 1,000 proposals of people with mental illness. In the first quarter of this year, in spite of the lockdown, we have approved more than 250 proposals,” Prakash told BusinessLine .

Star Health is creating a panel of psychiatrists to study the issue in depth and to make the coverage more comprehensive.

Health insurance, which was until recently only used for covering physical ailments, was extended to cover mental issues as well. In 2017, the Mental Healthcare Act stated that every insurer will have to make a provision for medical insurance to cover the treatment of mental illness, similar to the available treatment of physical illness.

Subsequently, in 2018, the Insurance Regulatory and Development Authority of India (IRDAI) made it mandatory for insurance companies to include the treatment of mental illness in their offerings. It also barred insurers from excluding mental illnesses, stress or psychological disorders, behavioural and neuro-development disorders from the comprehensive offerings.

“While it is clearly laid out in paper, its implementation is the key. It is an activity that we (as insurers) need to do. At Star Health, we wish to create a benchmark for coverage of mental illnesses and help develop the industry,” he said.

Spike in mental health disorders

Though instances of mental health disorders are widely prevalent in India, too often these are not reported due to the ‘taboo’ associated with it. However, the recent crisis has brought issues pertaining to mental health to the forefront.

According to the Indian Psychiatric Society, the fear of being infected and anxiety about an uncertain present and future in the wake of the pandemic have severely impacted the mental health of people.

Experts suggest a 20-30 per cent surge in teleconsultations by customers over the last two to three months seeking emotional and psychological well-being.

“It is estimated that close to 200 million (20 crore) people have varying degrees of some mental disorder and that is the reported number….the actual number could be higher,” said Anika Agarwal, Direct Digital Business and Marketing, Max Bupa Health Insurance.

Max Bupa’s insurance plan GoActive comes with OPD coverage. It has also introduced behavioural counselling for its customers who wish to take special counselling from a psychologist or psychiatrist.

“The need of the hour is for more comprehensive health cover which includes mental health, both in hospital and out of hospital, rather than specific or standalone products for mental health,” she said.

One of the key challenges in evolving a product for mental health is the assessment of risk and pricing it appropriately, said Sanjay Datta, Chief Underwriting, Claims & Reinsurance, ICICI Lombard General Insurance.

Published on June 30, 2020