Is home care treatment add-on with existing health policy beneficial?

“The Insurance Regulatory Development Authority of India (Irdai) has advised insurers to consider offering “Home Care Treatment” and/or “Domiciliary treatment” as an add-on cover to existing insurance products on charging an additional premium. This add-on cover would be quite relevant from a broadening of coverage perspective, especially during a pandemic, where most are treated at home, the situation is still uncertain & volatile,” said Biresh Giri, appointed actuary, Head – Product Development & CRO, ACKO Insurance.

Some health insurance policies already include home care treatment as an in-built feature of policy helps make reimbursement accordingly. While this is not a mandatory feature, the coverage can vary from one policy to another.

Home care treatment or domiciliary hospitalisation is a situation when the insured person avails of the health-related treatment at home. Although it is a part of the non-life insurance, it contains some mandatory guidelines such as at least 72 hours of treatment at home, to get the claim.

Looking at the sudden rise in the number of cases during the second wave, those who had home care treatment as an in-built feature made the best use of the policy as the hospitals had turned many of them away due to a shortage of beds, oxygen, medicines, leaving the patients with no other option.

Naval Goel, Founder & CEO, PolicyX.com, said this notification has come as a big help ahead of an expected third wave of covid-19. Now, people will be able to get treatment at home if there is shortage at hospitals.

“In the recent past, we have witnessed a huge requirement for home care treatment due to shortage of medical facilities where people had gone under home quarantine or even had made an ICU facility at home. Considering the same situation, the aim is to ensure that the customer gets paid for the home care treatment without any financial worry with a minimal addition in the premium,” Goel said.

Will it be beneficial for buyers?

Shankar Bali, Joint MD, Vidal Health, said, “The regulator’s decision will now permit people to add a domiciliary hospitalisation cover/home treatment cover to their existing health policy as an add-on. Most health policies do not offer a domiciliary cover, the experience during covid-19 has shown that this could be useful. If the underwriters’ price this well, it can get high penetration among the covered populace. It can be a great addition to premiums as well as provide peace of mind to people that even if they get treated at home, their health policy will cover the medical expense.”

“With this modification, the insurers will now be liable to pay the medical expense incurred from day one of home care treatment,” he added.