Kolkata: The third wave of omicron induced may have infected more than the two waves of the previous Covid-19 pandemic, but the average size of insurance claims in this wave is far less than witnessed during the second wave of deadly last year.
Most of the leading insurance companies and third-party administrators (TPA) have seen 20% -30% in the size of the claim and decrease in the total number of January, when the third wave peaked.
Insurance claims are now mostly in the range of Rs 70,00-80,000, they said.
Jyotirmay Kundu from Heritage TPA said they had seen more than 30% decrease in claims in the city this month during April-May 2021, the second wave peak.
This is because there are fewer complicated cases and hospitals stay up to 4-5 days from 8-9 days before, he said.
“We witnessed very few ICU cases and this time and even in the ICU case, the necessary intervention is not much and the patient will run out faster.
The use of sacrificial medicines is also lacking,” said C bera, branch manager, Raksha TPA in Kolkata , explaining why the cost of hospitalization has dropped.
The Raksha TPA manager said that for Covid ICU patients, the average insurance claim was Rs 4-5 Lakh during the second wave, which now dropped to Rs 2.5-3 lakh.
Staying at the hospital for non-ICU patients Covid also fell from 10 days earlier to five days on average now, he said.
However, insurance companies say that billing can be higher for patients who choose expensive antibody cocktail care even though the new therapeutic costs themselves have dropped from Rs 1.2 lakh per person to 70,000-75,000 with several hospitals that introduce child care packages.
Earlier this month, IRDA insurance regulator has suggested insurance companies not to refuse antibody cocktail therapy claims with the pretext that it is experimental treatment.
Sanjay Datta, Head, Guarantee and Claims, General Insurance ICICI Lombard said the claim size has dropped because the treatment protocol in the third wave is simpler.
Priya Deshmukh Gilbile, Chief Operating Officer, Manipalcigna Health Insurance said the average claim size reported by the company this January has been Rs 1-1.2 lakh against Rs 1.5-1.7 lakh as long as most patients have mild to currently.
Symptoms that do not require critical care.
A national insurance official also confirmed that there had been a decrease in the size of the claim in the latest waves.