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The settlement of Covid-related health insurance claims is hovering around 60 per cent of the total claims made so far.
According to the latest industry data, as on July 19, 2021, total reported claims stood at ₹27,640 crore, of which, only claims worth ₹16,396 crore have been settled.
On an average, the settled amount ranges between 55 per cent and 65 per cent of the claim .
In the first wave of the pandemic (up to February 22, 2021), insurers reported claims worth ₹13,736 crore, of which ₹7,125 was settled. In the second wave – from February 23 to July 19 – general and standalone health insurers received claims worth ₹13,905 crore, of which ₹9,271 crore has been settled.
When contacted, the chief of a private general insurer said: “Settlement of Covid claims has been a challenge as most customers tend to claim much higher than what they are eligible for under various schemes.
“In some cases, claims are not supported by valid documents. In very few cases, we have detected fake documents, including Covid certificates.”
Intensity of second wave
The intensity of the second wave of the pandemic is also testified by the number of claims.
“The number of claims we received during the few months of the second wave are higher than the claims reported during the entire first wave of Covid-19,” said Sanjay Datta, Chief - Underwriting & Claims, ICICI Lombard said.
According to TA Ramalingam, Chief Technical Officer, Bajaj Allianz General Insurance, Covid claims constituted 45 per cent of the overall health claims during the first quarter of the current fiscal compared to 17 per cent in the same period last year.
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