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Insurance companies are not doing enough for COVID-19 doctors and healthcare workers

02-Jun-2021

Last week one of our hospital clients wanted to buy group term life insurance for its staff. A similar request came from a group of nurses to buy health insurance for members. However, insurers’ appetite for underwriting such risks is low.  Doctors and medical staff are categorized as a high-risk group due to their exposure to the coronavirus and the resultant morbidity and mortality. Across different social media news feeds, it is common to see announcements from companies about the help they are extending to their employees and their family members who are affected by COVID-19. A lump-sum benefit on death, or health insurance for their family members are the commonly cited benefits. Unfortunately, such measures are not as common for the medical fraternity.

A less-insured group
Doctors are among the relatively less-insured occupational groups. A large number of doctors work as independent professionals. So, they do not have employer-sponsored health or life insurance covers. Ideally, doctors and paramedical staff should have easy access to high-quality healthcare, at times for free. The reality of the profession though is different. When an independent dermatologist goes to a multi-specialty hospital for treatment, she doesn’t get any special waivers at the billing counter. The old-world courtesies of doctors not being charged have reduced.

Various government bodies and the insurance regulator IRDAI have tried to take several steps to help COVID-19 warriors. There was a government announcement of a life insurance benefit for doctors who die while treating COVID-19 patients. The IRDAI, for its part, had asked insurers to issue the Corona Kavach – a special health insurance for COVID-19 – at a discount to healthcare professionals. Much of this has not translated as real benefit on the ground. Doctors are unsure about who is covered under the announced death benefit scheme. What happens when a doctor dies due to corona but not while treating COVID patients? Similarly, on the Corona Kavach policy, not many insurers have been aggressive in promoting this product, especially to doctors. If the number of new Corona Kavach policies issued monthly were to be published, I suspect, it will show a declining trend, more so for doctors.

Difficulty in accessing coverage

Even employer sponsored coverage is hard to come by for hospitals. Group health insurance for hospitals is undertaken by only a handful of insurers, mostly the public sector ones. A big reason to decline coverage is a possible moral hazard that hospitals may influence the in-house billing. Group term life is difficult for doctors to procure due to the heavy exposure to the coronavirus and high mortality rates. In fact, an insurer who recently launched a COVID-only death plan, put doctors on the caution list for underwriting.

In all fairness, doctors do have a high-risk exposures, so insurers’ caution is not misplaced. However, to keep this pool out of the coverage net may be counterproductive in the long run. Hospitals and doctors are an integral part of the insurance ecosystem. Of course, the entire health insurance industry depends on the functioning of health-care providers. The life insurance industry depends on the health care delivery system for the pre-issuance medical underwriting. Doctors today feel highly insecure about their own safety and the livelihood of their families should something happen to them.

Many of us have lost a friend or relative to COVID. After reading about the treatment process for mucormycosis, a chill going down the spine is not unusual. Imagine the plight of doctors, who may have lost a close colleague they meet every day. Or, the courage it would take a doctor to explain the mucormycosis treatment surgery to a mother of a 30-year-old. Inequalities in society always lead to issues. A high proportion of uninsured doctors may lead to unintended consequences. We already hear stray stories of excessive billing or black marketing that involved medical professionals. This may be an early symptom of a larger underlying issue.

What insurers can do

The insurance industry has solved several complex issues in the past, such as insuring HIV patients, and can easily crack this conundrum too. It just needs to become a priority. For starters, insurers could be asked to start reporting the coverage base of doctors, especially for health and life insurance policies. A public reporting itself would nudge the insurers substantially.

A more assertive way would be to make this as a part of their social sector obligation. On the regulatory side, there could be a specific waiver in the definition of group formation for doctors. Insurance laws prohibit group formation principally for the purpose of buying insurance. Doctors have several small groups, which are largely informal. These groups may not comply with insurance laws today.

We could take a cue from international markets, where companies such as Bought By Many helped several groups with common interests to buy insurance covers in a cost-effective manner.COVID-19 has taken a toll on everyone. Doctors have been more affected than several other occupational groups. Some professionals such as dentists have lost their regular income due to the lock down. Several doctors have lost their lives while treating COVID patients. Just as several employers step up the social security net for their employees, we must do the same for our COVID warriors.

Source : Money Control

 
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