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Average ticket size of health claims for Covid patients up 20-50% in second wave of the pandemic | India News


CHENNAI: Even as the hospitalization period was cut in half in the second wave of the pandemic, the average size of health claims for Covid patients increased from 20% to 50%, compared to the peak in the first. wave in 2020.
Director of Underwriting, Products and Claims at Max Bupa health insurance, Bhabatosh Mishra says we saw the average claim ticket size go up from Rs 1.3 lakh to Rs 1.5 lakh. “The hospitalization period has decreased from an average of 14 days to 7-8 days in recent months,” he said.
“The increase in the size of the bill for Covid-19 treatment is largely due to hospitals charging separately for oxygen cylinders and equipment used in the ICU. I don’t understand why they should charge for the ICU team separately? The use of high-priced drugs has further led to a high cost and therefore a larger claim size, “Mishra told TOI.
Hospitals and insurance companies usually agree to the hospitals’ rate as part of an agreement that can last for 3 years, which includes the cost of the ICU room.
A member of the General Insurance Council, which is a representative body of insurance companies formed by the Insurance Act of 1938, said that there is an average 20-25% increase in the average ticket size of settled Covid health claims. “This is due to the number of cases that had comorbidities and required additional medical treatment, including more expensive medications.”
For example, in the second wave of Covid, the claim amount could still be 1 lakh of rupees, similar to the first wave. However, the number of days of hospitalization would have been reduced from 18 to 9 days. In such cases, the bill amount remains unchanged in both periods, however, the hospital’s daily charges may increase.
ACKO (General Acko insurance) observed that the average ticket size of such claims has increased by more than 50%, with a sharp increase of more than 100% in Covid-19 claims in the second wave than in the first wave.
Their senior vice president (senior vice president) and chief claims officer, Suman Pal, said that “the majority of critical patients were hospitalized, requiring more aggressive medical intervention and prolonged periods of hospitalization, during the second wave. It ranged from 8 to 15 days. The average ticket size resolved so far is approximately Rs 1.48 lakh ACKO for such claims, but in some cases the claim size has increased substantially. ”

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