The insurance landscape in India is often found to be lacking when it comes to mental health coverage, despite the Insurance Regulatory & Development Authority of India’s (Irdai) mandate to include coverage for mental illness. A report by Marsh McLennan India and Mpower found that less than 1% of total health insurance claims in India are for mental health treatment. Additionally, 42% of participants in a survey were either unaware of their mental health coverage or did not have it. Furthermore, addiction treatments and rehabilitation centers were often excluded from insurance policies, creating further barriers to care.
Psychiatrist Dr. Harish Shetty stressed that getting an insurance claim for mental health patients is a struggle, and many patients are unaware of their coverage. He also pointed out that insurance firms frequently rejected claims from patients who attempted suicide, and even denied claims for physical ailments due to patients being on psychiatric medication.
The report highlighted that health insurance coverage can protect individuals from catastrophic health expenditures, but this is not the case for mental health patients. Section 21(4) of the Mental Healthcare Act (MHCA) mandates that insurance coverage for mental illness be on par with that for physical illness, but many insurance policies exclude coverage for mental illness or specific conditions, such as attempted suicide or substance abuse.
The article analyzed insurance policy documents and found that many policies excluded coverage for mental illness, in direct contradiction of MHCA and Irdai’s guidance. The report concluded that the insurance landscape in India remains fragmented, and that more needs to be done to bridge the gap in mental health coverage.