Females file more health insurance claims
An increasing ‘number of insured covered under corporate health insurance are claiming for maternity benefits.india Updated: Jan 08, 2009 21:15 IST
An increasing ‘number of insured covered under corporate health insurance are claiming for maternity benefits. No doubt this has led to females claim in larger numbers and higher amounts in health insurance policies than males according to data collected from the 28 third party administrators (TPAs) for the year 2007-08 and released by the Tariff Advisory Committee.
A total of 6,50,070 females claimed Rs 1,359 crore from non-life insurance companies with the average claim being Rs 20,903. On the other hand, the number of claims from males were 6,08,023 and the claim paid was Rs 1,150 crore with an average of 18,922.
Most corporate health insurance policies cover the employee, his spouse and dependants (parents or children) and include maternity benfits.
Explaining the reason, Sajal Dutta, head customer service (health insurance) at ICICI Lombard General Insurance, said, “The basic reason is that most corporate policies provide maternity benefits where claims are registered the most. Secondly, delivery is tending towards cesarean rather than normal delivery. The average claim for a cesarean is Rs 30, 000 to 35, 000 while the average claim for a normal delivery is Rs 20,000 to 25,000. Both these bring more number of claims and a higher average claim amount.”
Lifestyle related diseases such as heart, diabetes, hypertension, degenerative diseases which manifest between the age group 41-60 years led to the highest number of claims (4.3 lakh) with a claim amount of Rs 1,001 crore from people between the age group 41 to 60 years.
Although the share of individual premium in the total premium collected was 51 per cent compared to group floater premium which had a share of 33.9 per cent in the total premium, insurance officials say that the average premium for a corporate policy is much lower by 40 to 50 per cent than the average individual premium.