Maharashtra has 35% of Covid-19 cases, and 60% of insurance claims

MUMBAI: Roughly one-third (35%) of all Covid-19 cases in India are from Maharashtra, but when it comes to insurance claims from those treated for the virus, 60% are from the state, according to data from IRDAI. Insurers attribute this to two factors – one, the higher penetration of insurance in Mumbai and Pune compared to other metros; and two, that there is more testing, hospital capacity and beds available in Mumbai.

Delhi and West Bengal also have a higher percentage of people opting for private health insurance care compared to the proportion of cases. Delhi has 11% of all cases but 15% of claims; likewise,West Bengal has 3% of all cases and 5.4% of claims. But none of these states have a disproportionality as stark as Maharashtra’s.

Insurers say this is because on many financial indicators like active investors in the stock markets or mutual fund holders, Mumbai has the lion's share. "We sell more insurance in Maharashtra than anywhere else in India. Individuals in Mumbai and Pune have always been aware on the need for health insurance even before the pandemic...Maharashtra certainly has a higher insured population," said Sanjay Datta, chief underwriting claims, ICICI Lombard Insurance Co.

Another reason why Maharashtra could be getting more claims at this juncture is because its government healthcare system is getting overwhelmed. "States like Kerala and Karnataka have lower cases and lower claims; their government healthcare infrastructure hasn't reached tipping point. That is not the case with Maharashtra," said an official with the National Health Authority (NHA) of India.

It is also possible that higher private health insurance claims are being recorded because of higher hospital capacity and number of beds in the state, said insurers. The state accounts for nearly one-fifth of the 35,000 hospitals in the Rohini network, a chain of partnered hospitals of insurers.

"It is also possible other states are just not testing enough; and people are being sent back home because private hospitals don't have the capacity or the testing equipment/facilities to handle Covid-19 patients," said an official with the National Health Authority (NHA) of India. Insurers also say that government policies in different states, access to testing/ treatment in private healthcare, availability of resources, could have all led to this disproportionality.