25 July 2011
By, Khyati Dharamsi & Preeti Kulkarni
These policyholders can now breathe easy as some insurance firms have started including such alternative forms of treatment under their cover, especially ayurveda. “Ayurveda being the most prevalent of the alternative systems, we have designed a product to cover treatments under ayurvedic hospitalization,” says S S Gopalarathnam, managing director, Cholamandalam MS General Insurance.
While some insurers only offer it under their group policies, others have started offering the facility to individuals. PSU insurer New India Assurance and standalone health insurance provider Star Health and Allied Insurance are some of the companies that have started covering ayurvedic treatments under individual policies. ICICI Lombard General Insurance covers it under government scheme and Future Generali Insurance offers it to corporate group insurance buyers.
“Our policies do not cover any other line of treatment other than allopathy. However, in group policies, if requested, we do offer tailor–made packages to corporate clients to cover ayurvedic treatment subject to certain conditions,” explains Shreeraj Deshpande, head, health insurance, Future Generali.
BOOSTER SHOT No standalone cover for alternative treatments
Some insurance firms have started including alternative forms of treatment like ayurveda under their cover. How did this need to cover alternative forms of medicine in health insurance arise? Gopalarathnam, explains, “During various focus group discussions with customers and agents, we found that for chronic ailments like spondilytis, arthritis and epilepsy, many people preferred alternate streams of treatment such as ayurveda, siddha and homeopathy etc.”
Though the coverage has been expanded, there are curbs on the amount and situations under which it can be claimed. New India Assurance’s extends cover to individuals undergoing treatment with the help of Ayurvedic, homeopathic and Unani systems of medicine. “Such claims will be covered only to the extent of 25% of sum insured. Also, they need to have availed of the treatment at a government hospital to be eligible for the claim,” informs Segar Sampathkumar, deputy general manager, New India Assurance.
Similarly, Star Health also covers non–allopathic treatment, except Naturopathy, costs under its Unique Health Insurance Policy, “up to 25% of sum assured or a maximum of Rs 25,000 per occurrence, per year.”
Chola Individual Health line Insurance policy provides coverage for ayurveda during hospitalization, prior and post hospitalization. A policy holder can get treated in any of the government registered ayurveda hospitals across the country and claim if hospitalized for more than 24 hours.
Naturopathy treatments are excluded in all policies, while few cover unani and homeopathic. This is because other forms of treatments have no standard treatment protocols and highly varied costs thus making it difficult to actuarially compute the cost to be covered. Even under ayurveda, select procedures are covered to ensure people do not misuse a policy for a basic rejuvenation procedure.
“We do not cover the unani system of medicine. Under ayurveda, hospitalization for panchkarma (five actions) meant to purify the whole body by eliminating accumulated toxins, is covered on a case to case basis,” explains Deshpande.
It is important to note that there is no standalone cover available for covering alternative treatments. You will have to buy a standard health insurance cover from these select insurers and others who start offering the non–allopathic coverage.
Before you head for alternative treatment and make a claim, see whether the treatment is listed in the insurance policy document. Insurers are particular about the specific treatments covered. “Snehan and Swedan are payable only when these procedures are done as a part of pre–panchkarma preparation. Comfort treatments involving steam bath/ sauna/oil massages are excluded,” Deshpande adds.
Similarly Gopalarathnam says, “We have identified about 40 common ailments for which ayurvedic treatments are prevalent and widely used, which we cover for treatment across any government registered hospitals.”