The insurance regulator IRDAI has asked insurance companies not to deny insurance to persons suffering from HIV/AIDS in India, unless their decisions are supported by actuarial studies.
“Insurers must cover the condition either under comprehensive health plans or design separate products for patients suffering from it,” said Mr Subhash Chandra Khuntia, IRDAI chairman. The premium calculation will depend on actuarial assessment and data analysis by the insurers, he said.
The regulator's directive was given to comply with the HIV and AIDS (Prevention and Control) Act, 2017 which took effect on 10 September. The Act bars insurance companies from discriminating against HIV-positive individuals.
According to National AIDS Control Organisation, there were an estimated 2.14m people living with HIV in India at the end of 2017.
Insurance officials told Moneycontrol that the premiums will be very high for HIV/AIDS patients. For instance, if an average health insurance premium is INR7,000 ($96) per year, it would be 2.5-3 times that for an HIV-positive patient. Similar differences in premium will also be seen for life insurance coverage of a healthy person compared to that of an HIV-positive patient.
According to a Bloomberg Quint report, insurers say pricing HIV/AIDS insurance will be a challenge till there’s enough historical data.
Mr Ashish Mehrotra, managing director and CEO of Max Bupa Health Insurance, said, “Experience from international markets and reinsurers would have to be used to decide the premium rates.”
Insurers have agreed that those covered under existing health insurance plans will also be covered for HIV/AIDS only if the condition was detected during the insurance period.
“If an insured person gets diagnosed with HIV/AIDS, then that person will be covered under the basic health cover,” said Mr Sanjay Datta, chief of underwriting and claims at ICICI Lombard General Insurance. “A separate optional cover must be designed for those who declare themselves HIV-positive, the premium for which would be higher than basic health plan.”
Prior to the law taking effect, HIV/AIDS was excluded from all health insurance plans in the Indian market, barring a group policy by Star Health and Allied Insurance which was launched in 2010.