August 10,2024
Mumbai: Nearly a third of the health insurance claims recorded by insurers are due to seasonal infectious diseases. These include vector-borne diseases such as dengue and malaria, which give rise to high claims in July and August, or water-borne infections such as gastroenteritis. In winter, it is usually bronchitis or influensa.
As many of these claims are related to hygiene conditions in the locality they are avoidable to a large extent. However, they impact all segments of society as evident from claims data.
According to a study of reported health insurance claims by Policybazaar, vector borne diseases like Dengue and Malaria account for 15 per cent of total seasonal illnesses claims. The cost for treating these mosquito-borne diseases typically ranges from Rs 50,000 to Rs 1,50,000. These claims surge in July and August when humid conditions create ideal breeding grounds for mosquitoes.
Another illness that peaks during the monsoon is gastroenteritis or stomach flu which has the same treatment expenses as Malaria. This ailment accounts for 18 per cent of seasonal claims. Another 10 per cent of seasonal illness claims are due to allergic reactions where the periodicity varies according to region. Winter sees claims due to influensa and bronchitis peaking to 20 per cent and 12 per cent of seasonal illnesses. However, the cost of treatment is lower ranging from Rs 25,000 to Rs 1 lakh.
“If you look at developed countries, the share of seasonal illnesses is much lower compared to developing countries. In case of India, even in developed parts of the country like Gurgaon there are problems of water accumulation and mosquito breeding which leads to an increase in these claims,” said Siddharth Singhal, head of health insurance, Policybazaar.
“These seasonal illnesses add to the frequency of claims. However, the average claim amount is much lower than chronic illnesses, and in terms of value, the share of claims would be below 20 per cent ,” said Singhal. According to Singhal, the cases of hospitalisation for illnesses that would have earlier been treated at home have gone up. “This is a positive development as it is always good to have professional support. ,” he said.
Source: Healthworld