Pre-packaged med insurance not feasible, firms tell HC

Nov 29 2013, 04:54 IST
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SummaryHealth Insurance companies on Thursday told the Bombay High Court

Health Insurance companies on Thursday told the Bombay High Court that it would be difficult to introduce pre-packaged compensation for 42 ailments covered under medical insurance on the basis of the sum insured and the type of hospital.

The court had on August 2 asked the Insurance Regulator and Development Authority (Irda) to issue guidelines to insurance companies, requiring them to come out with a pre-packaged scheme for the 42 aliments.

However, their lawyer today said such packages were not easily accepted by the hospitals. Also, sometimes the hospitals had the tendency to overcharge.

Also, hospitals can not be graded, the companies said. The division Bench headed by Chief Justice Mohit Shah gave the insurance companies four weeks to file affidavit explaining why Prue-packaged compensation can not be introduced.

However, activist Gaurang Damani, who has filed a public interest litigation in the HC on the issue, argued that grading of hospitals was not necessary; package rates can be determined in proportion with the sum insured.

Talking about the flaws in the current mediclaim system, Damani said there have been instances where different insurance amounts were given in different cases for the same treatment at the same hospital.

If pre-packaging is made available, then the insured person would be able to choose the kind of hospital where he/she wants to be treated, he contended.

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