Insurance compaÂnies say that providing life or health cover against HIV viÂrus will be a challenge as inÂcluding AIDS in general poliÂcies will push up the costs for all buyers.
“The pricing of health inÂsurance is based on the freÂquency and average claims seÂverity In case of AIDS, the average claim would be very high and it is very likely that the sum insured will be the claimed amount. This would require general pricing of health insurance to be reÂvised,” says Shreera Deshpande, head of health insurÂance at Future Generali Insurance. “Internationally wherever Insurers have made an attempt to cover HTV-infected people it has been done in a very restrictive manner,” Deshpande says.
Star Health and Allied InÂsurance covers HIV in associÂation with an NGO. The cover is in the form of a limited lump sum benefit if the HTV perÂson is diagnosed with AIDS.
Last week, IRDA asked life and general insurance companies to look at ways to provide cover for those inÂfected by HIV and those exÂposed to HIV virus. At preÂsent, insurers exclude HIV individuals from life covers.
While health insurance providers are daunted by the claims, life insurers are unÂwilling to cover HIV indiÂviduals because they feel that this is unchartered territory Covering HIV individuals involves a host of challenges, says Kamalji Sahay MD and CEO, Star Union Daiichi Life Insurance. “Unlike in some developed nations where all citizens have the right to access treatment across the country, in India there is no uniform facility for treatment across the country and longevity is subject to certain level of standard treatment,” he says.
“It would definitely call for a new set of underwriting guidelines to insure known ‘risks’. Pricing would be the key in insuring this niche set of population,” says Frederick Dsouza, senior vice-president, underwriting and claims, HDFC Life.
Life Insurers say their policies will pay out for death caused by AIDS if the virus is contracted after the policy is purchased, but there is some uncertainty According to HDFC Life, the company would pay the claim after investigation, though it would depend on a case-to-case basis. Today insurers are willing to provide high-value term cover of up to Rs 50 lakh without medical underwriting. In such cases, it is not possible to ascertain whether the buyerwas infected or not at the time of taking a policy “If the disease is contracted after taking the policy, we will pay the claim,” said Sahay.
Times of India, Mayur Shetty
