Now, health insurance to cover OPD charges

Mumbai: There is good news for health insurance buyers as insurers are now beginning to cover outpatient department (OPD) expenses as well. At least two players - Apollo DKV and ICICI Lombard - have come out with such a policy that was so far denied by insurance firms on fears of misuse by policyholders.

Apollo DKV's Maxima and ICICI Lombard's Health Advantage Plus come at a fixed annual premium of 13,000 and 15,000, respectively. Unlike other medical insurance policies - which require a minimum 24-hour hospitalization - the sum assured is linked to the age of the policyholder. To check against possible misuse, companies have for the moment, decided to cap the OPD expenses, reports Business Standard.

However, one can claim OPD charges only once during the during policy term. In addition, both the policies do not allow, an insured person to claim OPD cost within 90 days of commencement of the policy. To claim for OPD expenses, a policyholder will have to submit the doctor's prescription and medical expenses bill. "The whole idea of covering OPD expenses is to ensure early detection of diseases, and this will lead to better healthcare," ICICI Lombard's Head of Health Insurance Sanjay Dutta said.

The move is part of a strategy to step-up focus on the retail segment as general insurers are saddled with losses on corporate health insurance, something that they were doling out for free to get the fire and engineering business over the last few years. In recent months, insurance companies are increasingly focusing on reducing claims and have gone to the extent of terminating a corporate health insurance policy midway through the term. In addition, they have got the insured employees to shell out a part of the claim.