Insurance coverage of TB negligible in India
Although India carries a huge burden of tuberculosis (TB), only a miniscule number of patients are covered by insurance as health insurers have not yet penetrated to the economic classes, which register a higher incidence of the disease.
As per World Health Organisation data, India has the highest incidence if TB with 2.2 million out of the global 9.6 million cases in 2011. This number was revised to 2.8 million in 2015.
It, however, claims TB account for less than five per cent among most of the health insurers. In case of Star Health and Allied Insurance, it is just about five per cent. TB makes for one per cent of the total health-related claims of Bajaj Allianz General Insurance and in case of United India Insurance too it is very small percentage of the total health claims.
“Health insurers largely cover upper class, middle urban and middle rural population. The incidence of TB is higher among the lower strata of rural and urban masses, which is not covered by them. A lot of affected people are treated as out-patients and hence that too goes uncovered. Insurance companies come in to the scene when other complications arise out of TB and require hospitalisation,’ said S Prakash, senior executive director, Star Health and Allied Insurance.
The central and state governments along with other agencies have been working on TB control programmes, but the insurance sector has not been involved in these programmes.
According to C R Vijayan, general manager, Health, United India Insurance, TB in India has not reached to a level where any agency has asked the insurance companies to devise a product. “If there is a demand, we will look into it,’ he said.
Though states like Bihar, MP and West Bengal are among states reporting higher prevalence of the disease, eastern and central region together account for less than six per cent of the total claims of Star Health. Health insurance penetration is lower in these regions.
Further, the insurance coverage has not been growing commensurate to the growth in the incidence of the disease. Over the last three years, the number of claims reported at Bajaj Allianz for TB and related ailments has grown at 2 per cent CAGR. However, the average claim size has grown by 7 per cent in the past three years. The average claim size for TB at Bajaj Allianz ranges between Rs 34,000 and Rs 38,000.
The incidence of TB among men has been historically high compared to women and it has been growing year-after-year. Men accounted for 51.08 per cent of TB claims of Star Health which grew by 2.16 per cent in 2016-17, while claims made by women de-grew by over two per cent.