Indian insurers have doubts about pricing and designing mandatory HIV / AIDS coverage

"This is a step towards eliminating any unlawful discrimination against HIV / AIDS patients by health insurance providers," said Alok Saxena, deputy secretary at the National Aids Control Organization, by phone. "The availability of insurance would ensure better access to private health care for long-term care and treatment of infections due to low immunity in patients."

But pricing remains a challenge. And that could be due to lack of data and experience, said Ashish Mehrotra, executive director and general manager of Max Bupa Health Insurance Company. "The experience of international markets and reinsurers should be used to decide the premium rate."

Anurag Rastogi, Head of Retail Subscription and Claims at HDFC ERGO General Insurance Company Ltd. "We are analyzing past actuarial studies to determine the additional premiums billed by global insurers to cover the illness and the medical costs of treating them."

Mehrotra – while stressing that patients with HIV / AIDS have the right to free diagnosis and treatment in public hospitals – said it took between 7 and 10 years for HIV to progress to AIDS. "Since health insurance policies are renewable for life, the long-term impact of HIV patient coverage is crucial."

What do insurance companies agree to?

Insurers agree that people covered by existing health insurance plans will also be covered for HIV / AIDS only if the disease has been detected during the insurance period.

"If an insured person is infected with HIV / AIDS, he or she will be covered by basic health coverage," said Sanjay Datta, Subscription and Claims Manager at ICICI Lombard General Insurance Company. "Separate optional coverage should be designed for people who self-identify as HIV-positive, whose premium is above the basic plan."

Datta said that if a person subscribing to a health insurance policy ICICI Lombard was seeking coverage for HIV / AIDS when renewing his policy, she would receive the same coverage.

Rastogi from HDFC ERGO General Insurance was of this opinion. "We will monitor the experience of our claims for one year before revising premiums for basic health insurance plans," he said. "Until then, people already covered by our policies can make a claim if they are infected with HIV / AIDS during the validity of the policy."