Health insurance for people with HIV

February 10, 2012

(The views expressed in this column are the author’s own and do not represent those of Reuters)

The insurance regulator recently floated a proposal which mandates all health insurance providers to put an underwriting policy in place for covering people with HIV or those working closely with HIV+ persons, such as doctors and nurses.

This will come as a relief for those affected or working in the field as chances are they would be refused a health insurance cover in the current scenario. Under normal circumstances, insurance companies would refuse outright to cover such individuals or exclude it as a pre-existing condition and not provide any benefits.

It will be interesting to gauge the insurance companies’ response to this as these plans might create a ‘bleeding’ scenario. Since the risk here is known and is no more left to chance or at least not completely, the usual models of underwriting many not work.

However, the proposal floated by IRDA is flexible and leaves it to the insurance companies to specify their underwriting norms and even to set the loading limits on such plans. The cover can also be offered by way of riders for those not affected at the time of taking the plan but having subsequently tested positive.

Currently, only Star Health, which is a standalone health insurance company, provides such a plan. In this plan, the proposal has to be initiated by government agencies or registered bodies which work closely in the field of HIV. This plan too is a restricted benefit policy with a low coverage amount.

The other problem will be to get such individuals to come forward and declare their status. Given the potential social stigma attached to it, many individuals would be extremely reluctant. The experience of Star Health Insurance Company which has run such programmes will come in handy and the industry will benefit from it.

This is indeed a breakthrough move by the insurance regulator where no state intervention is being sought as support.

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