Q. I’m Sameer. Doctors have just diagnosed that my health condition involves both physical and mental issues. How will this impact my ability to obtain insurance? What are the options available when there is a complex dual diagnosis like mine?
Those grappling with dual diagnoses do find it challenging to get health insurance cover. Existence of mental health issues may be viewed as a heightened risk factor when they assess the profile before providing coverage. There may be more rigorous scrutiny during the underwriting process, which could lead to restrictions on coverage or a denial altogether.
Historically, many insurance providers have excluded mental health conditions or imposed long waiting periods, making it difficult for individuals to secure adequate protection. Things are changing and now mental health is included in most health insurance plans. However, obtaining such a policy after the diagnosis can be a real challenge.
For now, let us remain positive and explore possible options.
Specialised insurance plans In recent years, growing awareness of the need for more inclusive insurance coverage has led to the development of specialised plans for those dealing with dual diagnoses.
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In line with the provisions of the Mental Healthcare Act, 2017, the Insurance Regulatory and Development Authority of India (IRDAI) issued a directive on May 29, 2018, mandating that “every insurer must offer medical insurance for the treatment of mental illness on an equal basis as it is available for the treatment of physical illness.”
Some insurance providers responded by introducing policies explicitly designed to address both physical and mental health conditions, ensuring more comprehensive coverage. However, for individuals with dual diagnoses, the medical underwriting process becomes crucial. The likelihood of obtaining coverage depends on the risk appetite of the service provider, even though these policies may cover physical and mental illnesses for those currently in good health.
Group insurance through employers: In such cases, group insurance options offered by employers can be a practical solution. Numerous insurers now include mental health coverage as an add-on, and employers have the flexibility to select this additional coverage. Group insurance plans typically do not involve extensive medical underwriting, making them more accessible to individuals facing dual diagnoses.
Also Read: Can I port my group insurance plan into an individual policy?
Seek professional guidance: It can be challenging to find and then navigate the intricacies of insurance policies that cover physical and mental issues. You may want to seek the help of an insurance advisor or broker, who specialises in health insurance for individuals with complex health conditions.
Sameer, we would advise you to stay positive and draw solace from the fast-changing approach of insurance companies. Yes, please engage an expert to advise you to ensure that the policy covers your needs best.
International Money Matters Pvt Ltd (IMMPL) is a SEBI-registered investment advisory firm, established 22 years ago. If you have any personal finance query, click here to book a free call with our advisor.
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Published: 16 Mar 2024, 11:19 AM IST
Meet Mahtab Ahmad, known for his keen insights into the latest trends and news. Join Mahtab on his blog, where every post is a exploration of the ever-evolving now.