MUMBAI: The cost of treatment for common ailments that require hospitalisation has more than doubled in five years, data from insurance claims show. Health insurance claims for infectious diseases and respiratory disorders have been growing faster than medical inflation – which at 14% is twice as high as retail inflation.
Average claim for infectious diseases rose to Rs 64,135 in 2022 from Rs 24,569 in 2018, which is an increase of over 160% and a compound annual growth rate (CAGR) of 26% (see graphic), data from Policybazaar showed. The amount is higher in metros like Mumbai, where average claim for infectious diseases rose to nearly Rs 80,000 from about Rs 30,000.
For respiratory disorders, average claim increased to Rs 94,245 from Rs 48,452 – a CAGR of 18%. In Mumbai, the cost rose to 1.7 lakh from nearly Rs 80,000. While Covid has driven up treatment costs, an inflationary trend was evident in the two years preceding the pandemic.
“More than the cost of intervention, the cost of treatment has gone up. After Covid, there has been a significant increase in the share of consumables. These used to account for 3-4% of the bill, but now, at times, they make up 15%,” said Amit Chhabra, chief business officer at Policybazaar. Cataract treatment saw slower growth (54%) in claim size – the average amount rose to Rs 1.2 lakh from Rs 78,325 – as stays at hospitals have become shorter.
Raksha TPA’s CEO Pawan Bhalla said medical inflation outpaces the general rate as new medicines and processes, coupled with increased internet awareness, lead to more expensive treatment. “The increase in insurance penetration pushes up the demand and usage of health services, which escalates costs,” said Bhalla. The push by diagnostic service providers for tests in the general population also increases the detection of medical conditions and their subsequent treatment. Due to escalating treatment costs, health insurance coverage is inadequate every five years. “Those who depend on corporate covers are exposed, as corporates continue to buy group coverage with limits of Rs 3 lakh, despite the cost increase,” said Chhabra. Consumers faced with rising premiums face a major dilemma. Without individual cover, they risk exclusion if they develop a condition.