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ICICI Lombard Expert Blog
 

Further Clarity Required on Coverage for Mental Health Ailments

December 04 2018
treatment-of-mental-ailments

Treatment of mental ailments are to be covered under medical insurance products: IRDAI

After the introduction of the Mental Healthcare Act, health insurance companies are seeking further clarity on coverage for mental health related ailments. As per the Act, it is mandatory for insurers to provide medical insurance for treatment of mental illness, just like the one offered for physical illnesses. However, no clarity has been provided by the insurance regulator on what ailments should be covered under the policy.

Earlier, the Insurance Regulatory and Development Authority of India (IRDAI) had said that under the Mental Healthcare Act, insurance companies will have to provide coverage for medication and hospitalisation for the treatment of mental ailments under the medical insurance cover. Once, the provisions of the Act are implemented, all procedures pertaining to mental health will need to be covered by the health insurance policies.

Globally, suicides and injuries made on self, either intentionally or unintentionally due to a mental ailment are generally excluded from health insurance coverage.However, general insurers in India are waiting for IRDAI to provide more clarity and bring out a list of items that should be included in the Mediclaim policy and those to be excluded.

A senior official of a private general insurer said, “We are awaiting clarity from IRDAI. Without getting details of what is to be included and what can be excluded, we will not be able to design products." Currently, there is a dearth of health insurance products that offer full coverage for the treatment of mental health related ailments.

The IRDAI is expected to provide more clarity in this issue in the next few months. This may include details related to the policy structure and its exclusions.

*Source: Money Control

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