Now, mental ailments to be covered

Mental illness will now be included in medical insurance covers, which will help patients get quality medical care without creating a financial burden.

“Every insurer shall make provision for medical insurance for the treatment of mental illness on the same basis as is available for the treatment of physical illness,” said insurance regulator Insurance Regulatory and Development Authority of India (IRDAI).

The move follows the enactment of the Mental Healthcare Act, 2017, which came into force on May 29.

As the name suggests, the Act provides for mental healthcare and services for persons with mental illness, and also to protect, promote and fulfil the rights of such persons during the delivery of mental healthcare and services. It has mandated medical insurance for such illnesses.

At present, most medical insurance packages do not provide cover for such ailments. Some insurers have now introduced plans for unrelated conditions such as autism in children.

Insurers believe that the IRDAI directive will provide quality medical care to such patients and also remove the stigma from treatment. However, its inclusion could have an impact on premium costs. “It is very difficult to undertake an estimate at present. If there is a significant increase in the number and amount of claims and add to the portfolio losses, then obviously the premium will increase,” said Sanjay Dutta, Chief of underwriting and claims at ICICI Lombard.

“Mental health insurance is a move in the right direction by the IRDAI as it will help people suffering from such illness by bringing them at par with any other illness, thereby offering them equality in every respect,” said S Prakash, COO, Star Health and Allied Insurance.

He pointed out that mental health affects young people in the age group of 18 and 35 years with women often more affected than men.

Depression, phobias

Insurers also said that the medical insurance would include all doctor-certified ailments, but is unlikely to cover counselling for depression or phobias. “Insurers will act on this directive. But all of it is a new area for us,” said another executive.

According to the Act, “mental illness” means a substantial disorder of thinking, mood, perception, orientation or memory that grossly impairs judgement, behaviour, capacity to recognise reality or ability to meet the ordinary demands of life, as well as mental conditions associated with the abuse of alcohol and drugs. It, however, does not include mental retardation, which is a condition of arrested or incomplete development of the mind of a person, specially characterised by subnormality of intelligence.

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