Jul 18, 2021, 07:59PM ISTSource: TOI.in
Even as the period of hospitalization halved in the second wave of the pandemic, the average ticket size of health claims for Covid patients increased from 20 to 50%, as compared to the peak of the first wave in 2020. Director of underwriting, products and claims at Max Bupa Health Insurance, Bhabatosh Mishra says that we saw the average ticket size of claims go up from Rs 1.3 lakh to Rs 1.5 lakh. “The period of hospitalization has declined from an average of 14 days to 7-8 days in the last few months,” he said. “Surge in the bill size of Covid-19 treatment is largely due to hospitals charging separately for oxygen cylinders and equipment used in the ICU. Don’t understand why they should charge for the ICU equipment separately? The use of high-priced drugs has further led to a high cost, and therefore a higher claim size,” Mishra told TOI. Usually, hospitals and insurance companies agree on the hospitals tariff as part of an agreement that can last for 3 years, which is inclusive of ICU room cost. A member of the General Insurance Council, which is a representative body of insurance companies formed by Insurance Act 1938, said that there is an average increase of 20-25% in the average ticket size of Covid health claims settled. “This is driven by the number of cases which had co-morbidities and required additional medical treatment – which includes costlier medicines.” For example, in the second Covid wave, the claim amount could continue to remain at Rs 1 lakh, similar to the first wave. However, the number of days of hospitalization would have reduced from 18 days to 9 days. In such cases, the bill amount remains unchanged in both the periods, however, the per day hospital charges can go up.