“It’s a step towards removing any illegal discrimination against HIV/AIDS patients by agencies providing health insurance,” Alok Saxena, joint secretary at National Aids Control Organisation, told BloombergQuint over the phone. “Availability of insurance would ensure greater access to private healthcare for extended care and treatment of infections caused due to low immunity in the patients.”
But pricing remains a challenge. And that may be due to lack of data and experience, said Ashish Mehrotra, managing director and chief executive officer at Max Bupa Health Insurance Company. “Experience from international markets and reinsurers would have to be used to decide the premium rates.”
Anurag Rastogi, head of retail underwriting and claims at HDFC ERGO General Insurance Company Ltd., agreed. “We’re analysing past actuarial studies for guidance on the additional premium charged by global insurers for covering the condition and the medical expenses its treatment entails.”
Mehrotra—while pointing out that patients suffering from HIV/AIDS are entitled to free diagnostics and treatment at government hospitals—said it takes between 7-10 years for HIV to progress into AIDS. “Since health insurance policies are renewable for life, the long-term impact of covering HIV patients is critical.”
What Insurance Firms Agree On
Insurers agree that those covered under existing health insurance plans will also be covered for HIV/AIDS only if the condition was detected during the insurance period.
“If an insured person gets diagnosed with HIV/AIDS, then that person will be covered under the basic health cover,” said Sanjay Datta, chief of underwriting and claims at ICICI Lombard General Insurance Company. “A separate optional cover must be designed for those who declare themselves HIV-positive, the premium for which would be higher than basic health plan.”
Datta said that if someone with an ICICI Lombard health insurance policy seeks cover for HIV/AIDS upon policy renewal, they will get coverage under the same plan.
Rastogi of HDFC ERGO General Insurance concurred. “We will monitor our claims’ experience for a year before we revise premium for basic health plans,” he said. “Until then, those already covered under our policies can make a claim if detected with HIV/AIDS during the validity of the policy.”