Seeking medical insur ance reimbursements is no longer limited to emergencies of the heart and brain; come monsoon, claims for infectious diseases take centre stage.
V Jagannathan from Star Health and Allied Insurance Co said there is a notable spike in claims due to infectious and vector-borne diseases during monsoon.
Data available from ICICI Lombard General Insurance, one of the largest insurers, showed treatment costs over three years have jumped for most monsoon-related ailments. "The average claim for fever and common infections has increased by around 20% per annum," said ICICI Lombard's Sanjay Datta.
Statistics show one in five patients down with rainrelated illnesses suffered from fever along with infections.
Around one in seven such seasonal patients sought hospitalization for gastroenteritis.
ICICI Lombard's Sanjay Datta said while the average claim for treating fever and common infections has risen 20% per annum, the treatment cost for respiratory tract infections rose 18% and 12% in 2012 and 2013, respectively .
The data shows the maximum claimants are either from the pediatric age group or the most productive 26 to 35 years bracket. "Over 3,000 claims in the last three years came from those in the 26-35 age group and over 1,500 for the 0-5 age group," said Datta.
George C (name changed) was last week surprised to get a bill of Rs 90,000 for his father's hospitalization, which included a two-day stay in the ICU. " After tens of tests, the doctors told me his blood pressure fluctu ations were the result of an infection," he said. George is worried how he would have footed the bill for fever if not for his insurance policy.
Doctors say this increase in the cost of treating monsoon-related illnesses is mainly a reflection of the patient's delay in seeking treatment. "Most cases
of fever or even malaria don't need hospitalization. It is only when the symptoms cannot be controlled for three to four days that the doctor advises hospitalization. Hospitalization means it's serious and needs insurance cover," said Dr Gustad Daver, medical director of Sir H N Reliance Foundation Hospital in south Mumbai. Incidentally, most rain ailments haven't yet seen a spike this year. "We are seeing the usual number of malaria, dengue and typhoid, but there isn't a surge yet. Leptospirosis is the only disease that seems to have increased," said intensivist Dr Khusrav Bajan from Hinduja Hospital, Mahim.
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