Insurers don't cover HIV on likelihood of high claims: Sinha

Health insurers generally do not give coverage against HIV as it is an excluded product because of likelihood of high claims that may jeopardise pricing assumption of these firms, Minister of State for Finance Jayant Sinha said in Parliament today.
He was replying to a question as to why only a few companies are offering health insurance products to people living with HIV in India (PLHIVs).
"Normally, HIV is an exclusion under insurance product as people inflicted with HIV may be more vulnerable to the opportunistic infections arising out of this condition and therefore, the incidence of claims would be very high, which may potentially jeopardise pricing assumptions made while designing the products," Sinha said in a written reply in the Rajya Sabha.

Factors like appropriate data and risk-pooling also pose as challenges for designing such products at affordable rates covering people with HIV, Sinha said.
However, two health insurance products are being offered to PLHIVs by two stand-alone health insurers -- Star Health and Allied Insurance Co and Cigna TTK Health Insurance.
Further, the minister said the product design is in the realm of the insurance companies and acceptance of any risk is based on the underwriting policy of these firms.

As per information furnished by the Insurance Regulatory and Development Authority of India, he said insurance contracts are commercial ones between insurers and the insured.

"It is therefore necessary that the products designed by the insurance companies are financially viable and sustainable in order to enable them to discharge their liabilities towards claims as and when they arise," he said.
Hence, premiums collected shall be sufficient to pay the claims of those affected policy-holders covered under the insurance policy, Sinha noted.