World Mental Health Day is observed on 10th October every year. The theme for 2022 is ‘Make mental health and well-being for all a global priority‘.
In India when it comes to health, all the significance was given to physical health. Mental health was always disregarded. There were times when mental health or disabilities were not even covered by the health insurance companies in India. The Pandemic intensified the issue of mental health. Also, celebrities have been open about their mental health. There was an increase of 25% in anxiety and depression worldwide. In India, Out of every 20 people including children, one is suffering from Mental Illness. According to a survey conducted by Deloitte, 80 percent of the Indian workforce has reported mental health issues since past years.
Earlier, health insurance policies in India only covered physical illness but post covid, there is a significant increase in the mental health issues. It has become absolutely vital for the Insurance Regulatory and Development Authority of India to cover mental health or illness under the scope of health insurance. Unlike the earlier trend now, some insurers are providing coverage for mental disorders also.
Mental Healthcare Act, 2017: Legislation
In India, the Mental Health Care Act, 2017, made it mandatory for all the insurance companies to cover medical insurance for the treatment of mental health or mental illness of people suffering, in the same way as physical illness is covered. As per the regulations of IRDAI, psychological disorders, mental illness, neural illness and stress are covered under health insurance. Protections are given to persons with mental illness under Section 21 of the Act to ensure that they get equal treatment to persons with physical illness. Section 21 (4) ensure that there cannot be any discrimination in insurance coverage of mentally and physically ill patients. Section 212, of the Mental Health Care Act, 2017 recognizes the right to equality and it prohibits any sort of discrimination related to mental illness. With respect to the guidelines of IRDAI, Few Insurance companies have started providing the mental health coverage in their existing services ensuring the cashless treatment of a person suffering from the mental illness and also covering all the pre and post-hospitalization costs resulting in the reduction of the financial burden.
Though, the definition of mental illness lays down two prohibitions i.e., excluding mental retardation and, the outcomes of alcohol. . It becomes important for the person taking the insurance to be aware of all such exclusions to avoid claim rejection in the future.
Limitations of the Act:
- The key factor to be considered by the insurance companies is to determine the types of treatment to be covered under mental health insurance. Treatment of mental disorders not only requires medications but also rehabilitation, psychotherapy, and counselling which can cause financial crises to the person. A challenge to medical insurance companies is to decide the basis they will cover the insured, i.e. on the number of days of hospitalisation or total estimated time for treatment. As for mental illnesses, even the procedure of treatment differs from the physical illness. The act fails to directly address this in the legislation. This makes the insurers have an advantage to take benefit from this legal gap as some of them refuse to cover as a large number of insured individuals fail to receive treatment.
- The Act only provide treatment and care who attempted to commit suicide under severe stress. It failed to provide treatment for all suicide attempts should be covered by insurance companies or just only to those who diagnosed with a particular psychiatric illness before attempting suicide.
- The Act does not provide enough protections to people who are more exposed to potential mental illnesses due to stress or further factors .Mental illnesses can’t be allied to certain prevailing illness or existent habit, likewise Physical illness. Thus, underwriting becomes difficult, as they have to decide grounds for imposing higher premiums, if necessary. An insurance company can exploit this gap to justify higher premiums.
- Companies need information and access to medical history. The Act does not provide how and what type of information is necessary to share. Section 23 of the Act provides for the right to confidentiality. However, it does not specify on the quantum of information that has to be shared and the info that could be supported.
However, this initiative by IRDAI and the Mental Health Care Act safeguards a better life for the suffering person as well as for the family members by covering all the hospitalization costs and providing access to advanced health care facilities. But there is a need to take strict arrangements for the implementation of the act by IRDAI.