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A Surge in Claims Due to Seasonal Diseases
The health insurance sector in India is witnessing a significant rise in claims due to seasonal infectious diseases. According to recent data, nearly a third of all health insurance claims recorded by insurers are attributed to these seasonal illnesses. The most common among them are vector-borne diseases like dengue and malaria, which see a substantial increase in claims during the monsoon months of July and August, and water-borne infections such as gastroenteritis. These illnesses, often influenced by hygiene conditions in specific localities, have a widespread impact across all segments of society.
Vector-Borne Diseases: A Major Contributor
A study conducted by Policybazaar reveals that vector-borne diseases like dengue and malaria contribute to approximately 15% of total seasonal illness claims. The treatment costs for these mosquito-borne diseases range from Rs 50,000 to Rs 1,50,000. Claims for these illnesses typically peak during July and August when humid conditions create ideal breeding grounds for mosquitoes. Similarly, gastroenteritis, a common monsoon illness, accounts for 18% of seasonal claims, with treatment expenses on par with those for malaria.
Winter Woes: Influenza and Bronchitis
Winter months bring their own set of challenges, with claims for influenza and bronchitis reaching 20% and 12% of seasonal illness claims, respectively. Although the cost of treatment for these winter ailments is lower, ranging from Rs 25,000 to Rs 1 lakh, they still contribute significantly to the overall claims during this season.
Avoidable Yet Widespread
Siddharth Singhal, head of health insurance at Policybazaar, noted that many of these seasonal illnesses are largely avoidable. “If you look at developed countries, the share of seasonal illnesses is much lower compared to developing countries. In India, even in well-developed areas like Gurgaon, issues such as water accumulation and mosquito breeding lead to an increase in these claims,” said Singhal. He further highlighted that while these seasonal illnesses add to the frequency of claims, the average claim amount is much lower than that for chronic illnesses, keeping the overall share of claims from seasonal illnesses below 20% in terms of value.
A Shift Towards Professional Healthcare
Interestingly, Singhal observed an increase in hospitalizations for illnesses that were previously treated at home. “This is a positive development as it is always good to have professional support,” he added, indicating a growing awareness and preference for professional medical care among the populace.
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