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Insurance regulator asks firms to offer mental illness cover under health insurance

Insurance regulator asks firms to offer mental illness cover under health insurance

Insurance regulator asks firms to offer mental illness cover under health insurance
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By Anshul  Oct 20, 2022 6:43:10 PM IST (Updated)

Mental Health Act, 2017 says every insurer will have to make provision for medical insurance for treatment of mental illness on the same basis as is available for treatment of physical illness.

The Insurance Regulatory and Development Authority (IRDAI) has directed insurance companies to provide cover for mental illness under health insurance policies before October 31, 2022. This comes in line with the Mental Health Act, 2017 that says every insurer will have to make provision for medical insurance for treatment of mental illness on the same basis as is available for treatment of physical illness.

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In light of this announcement, insurers will have to setup supporting infrastructure in terms of mental illness treatment specific network hospitals, clinics and psychiatrists, which will in turn help standardise the cost of treatment across a variety of mental illness ailments, their scope and condition specific pricing, said Apaar Kasliwal, Executive Director, PolicyBoss.com.
Depression, anxiety, and stress are common in Indian culture. India’s population is increasingly feeling the strain of its growing mental health problems and in some cases, it has become a matter of national security. And, currently a mental health insurance policy might offer limited coverage and is an add on benefit under a health plan. However going further with the development in the mental healthcare infrastructure, the insurance companies will make the cover more extensive and standalone.
Commenting on the move, Saurabh Arora, Co-founder-CTO and Head of Healthcare, Plum said that the recent move by IRDAI is a great step towards recognizing that mental health is an epidemic and how critical it is for policies to cover therapy, not just limit it to hospitalization.
Adding to this, Kasliwal said, "With this, consumers will get absolute clarity on what all is covered under mental illness, to what extent and scope is the coverage, what part will be cashless and what will be basis reimbursement and finally what’s excluded. There is expected to be tremendous boost to preventive health care with regards to mental illnesses, given the higher level of awareness and acceptance, at an individual, society and now insurance levels."
This will aid standardization of mental illness treatments and policyholders will now have a better choice from network list of all relevant medical care facilities and service providers specializing in mental illness treatment.
Policyholders will now be able to diagnose and attend to mental illnesses at an early stage, minus any taboo, minus any hesitation, minus any fear of being marked out.
On the expectations, Amjad Khan, Director, Employee Benefit practice and International business, Anand Rathi Insurance Brokers Pvt. Ltd said that mental health insurance would cover expenses incurred if anyone has to be hospitalized under in-patient care due to any mental illness including diagnostics, medications, treatment costs, room rent road ambulance charges etc.
"Consulting and counselling cost can also be covered if there is an OPD extension availed under the mental health insurance. The pandemic has brought about renewed approach on mental well-being and the insurers would offer flexible solutions under the same making it evident on the growing need to have mental well-being as an essential part of the overall health Insurance coverage," he said.
It's important to note that India has the highest number of depressed individuals in the world, according to a World Health Organisation (WHO) report.
This means that one out of three individuals in India suffers from depression/anxiety or any other kind of mental issue. Owing to which projections show that India Inc will suffer massive economic losses due to the rising mental health conditions and the subsequent absenteeism and presenteeism could bring down productivity at alarming levels.
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