Insurance claim for daycare: Companies asked to explore possibility

HYDERABAD: Insurance regulator IRDA today said companies should explore the possibility of including daycare treatment in hospitals under health policies.

The Insurance Regulatory and Development Authority (IRDA) also asked the Union Health Ministry to look into issues of lack of scientific standardisation of pricing of various health procedures and lack of comprehensive database in terms of infrastructure and qualities, like hygiene of healthcare centres, across the country.

Commenting on inclusion of daycare under health policies, IRDA Chairman J Hari Narayana said, "The number and scope of daycare procedures have to expand within the context of insurance policies to enable these kinds of procedures to take effect and be incorporated."

Under daycare procedure, a patient who does not need hospitalisation beyond 24 hours, is admitted to a hospital for limited hours. The existing healthcare policies grants claim for patients for treatment for 24 hours or beyond in a hospital.

The regulator said the total spending on healthcare requirements in India is about Rs 3 lakh crore, of which a little less than Rs 1 lakh crore is the actual spending that has to do with hospitals.

On group health insurance policies, he said, "The competition for grabbing group insurance business was bleeding health insurance industry due to non-viable premium rates."

He also pointed out that there is no insurance coverage available now for HIV+ people or for those with mental illnesses. Another area of concern he said is the absence of policies for regular management of chronic illnesses like diabetes.