Flash surgeries a hit with insurers

By Aparna Ramalingam

CHENNAI: If you are slated for a short-duration cataract operation soon, don't worry. With a comprehensive health care policy, your medical expenses would be fully covered by the insurance firm even without an entire day of hospitalization.

With advancement in medical science offering procedures like laparoscopy and key-hole surgery, general insurers are seeing rising claims for day-care surgeries. Options for such procedures are normally inbuilt in healthcare policies.
For instance, 10% of health insurance claims of Bajaj Allianz General Insurance last fiscal came from day-care procedures.

"Around ten years ago, such surgeries accounted for only 1% of our overall claims. In terms of surgeries, cataract tops the list. Patients are increasingly using the day care option for radio therapy, chemo-therapy treatments, kidney stone removal and some other orthopedic procedures," Dr Renuka Kanvinde, associate vice president, health insurance, Bajaj Allianz General Insurance said.


With medical procedures getting better by the day, Kanvinde anticipates the share of day-care procedure claims to overall claims to move up to 25% within the next five years for her company. Similarly, Max Bupa too has seen claims pertaining to daycare procedures constituting 10% of the total claims registered last fiscal.

Insurers also state that such covers are popular with some customers who have to frequently visit a hospital for treatment. "In a lot of cases, the cumulative cost of treatment procedures such as dialysis may be higher than the expenses incurred on other forms of hospitalization, owing to the higher frequency of the former. And with growing awareness on health and greater usage of health insurance covers, more and more customers are using their health insurance covers for day care procedure claims," Manasije Mishra, chief executive officer, Max Bupa Health Insurance said. ICICI Lombard too saw over 10% of its claims last year from the day care segment.

Typically, the claim size for such day-care procedures ranges between Rs 22,000 and Rs 30,000 with claim amounts for longer hospitalization being around Rs 35,000. And while advances in healthcare have played a role in popularising day-care procedures, the emergence of specialized health care institutions has also helped.

"In the last few years, we have seen the emergence of standalone %healthcare hospitals and clinics in eye, dental and even bigger hospitals now have a separate wing for day care procedures," said Sanjay Datta, chief (underwriting and claims), ICICI Lombard.

But industry observers say it is still early days to assess the impact claims from day-care procedures would have on the overall bottomline of a company.


The Times of India