Your medical insurance may soon cover outpatient expenses

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Now you can go to your medical practitioner for outpatient treatment and may be you get the expenses paid up by the health insurance provider as per the new insurance policy which may soon come into existence. This OPD cover will be offered by the public sector general insurance companies along with the private sector general insurance companies. The cover may be extended worldwide and the policy holder can put up a claim even while travelling overseas.

The medical insurance till date has covered the policy holders against the expenses incurring from hospitalisation, surgeries and critical illnesses. The outpatient expenses have always remained out of its purview due to several reasons. Certain policies may include certain follow-up visits after hospitalisation due to surgery or other such reasons. The OPD almost covers 60% of the total medical expenses and still it goes uncovered. The public sector insurance companies like Oriental insurance, New India Insurance, National Insurance and United India Insurance are also planning to offer this cover outside India.

Some of the public sector insurers have already included the OPD insurance as a part of their health insurance policy. Though these plans are already there, the overall percentage of plans offering OPD cover counts to only 2%. The lesser number of plans covering OPD is due to the back office work associated with such policies. The claim frequency in such insurance plans is very high while the claim amount is also quite small as compared to other insurance claims. The administrative work in such policies is very high and that is why the ratio of such plans to the regular plans is low.

The OPD segment which was earlier kept unattended has now found takers and these OPD cover policies will also bring in more business to this insurance sector.

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