Impact on Health Insurance: Before and After Covid – A Comprehensive Guide

ByKumar Santosh

The word “Pandemic” is very much known nowadays, even a few years back. It has a very negative impact on human life as an economic and as well as in health.

The history of pandemics is very old like the Plague and smallpox thousands of years ago and pandemics like Cholera, Influenza, and Typhus hundreds of years ago and HIV/AIDS a few decades ago. As is evident from the trend here, some epidemics have always been on the earth and are still occurring.

Our scientists keep inventing treatments or vaccinations from time to time and a lot of money is also spent on this.

In the present situation, no matter how many types of epidemics have spread in the last few years, keeping in mind the expenses of its treatment, everyone needs to get health insurance. There is something important in this.

As you can see every 5-7 years some pandemic comes and lakhs of rupees are spent in the name of treatment, because people of our family cannot afford to die, now so post virus infection. Multiple kinds of medical symptoms are also seen. Here, if you already have health insurance and have sufficient amount to get treatment for any medical complication due to the pandemic, you can get treatment at the money of a health insurance company with some terms and conditions always.

Here we are just giving the example of one pandemic Covid 19 that has caused the death of lakhs of people all over the world and also created a negative impact on the economy of many countries. In a country like India, you have to spend everything yourself, you just keep paying taxes to the government from time to time, but if we do not have health insurance, we have to pay for the treatment ourselves.

According to an article by the National Institutes of Health (NIH), post-medical issues include dyspnea (48%), fatigue (32%), cough (25.6%), mental health (6%) and respiratory-related diseases with the highest number of 61.2% are still suffering, this article is from 2022, recently post-Covid-19 heart-related medical conditions are also being seen in people.

Now let’s talk about what is the nature of health insurance after COVID-19, which I would like to explain in a few points:-

  • Increase in no of claims frequency and Claim Amount.
  • Medical Inflation
  • Huge fake claim by the Insurance Mafia
  • Miscellaneous malpractice by Customers, Agents, Insurance Company Representatives, and Hospitals to file fake reimbursement / cashless claims.

I’m not here to blame all stakeholders but as per the report by the Insurance Institute of India there is 15% of health insurance claims are fake and insurance companies losing 600-800 crores rupees every year and it’s gradually increasing year after year. So now it turns to the insurance companies…..and Insurance companies doing the below strict action to minimize cost as below:-

  • Increase 3-4 times in premiums almost by all Insurance Companies, so it will be impact on all the policyholders
  • Blacklist of Hospitals
  • Geographical location, marking negative areas according to claim frequency and fake claims
  • Launching new products and discontinuing existing products due to a high claim ratio
  • Approval of Claim as per the various patterns
  • Agency Code Termination for those who have too high a claim ratio
  • Other bottom-line cost-cutting

As we have seen, many changes have been seen in the health insurance industry after Covid-19 and in the end, whatever loss is incurred, it increases the premium of the policyholder. To best underwriting practice is very important for all the stakeholders like Insurance Agents, Managers, Leaders and the customer himself. It is also important to disclose your health and past medical history.

About the writer – Kumar has more than 2 decades of personal finance Sales, Operations, Health Insurance Underwriting, and Health Insurance Claims, and has been associated with multiple training teams for Learning and Development

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