Denial of justice: Mediclaim does not cover treatment for any mental illness or psychosomatic disorder
Dr KK Aggarwal
National President Elect and Honorary Secretary General IMA
On 10th October we are observing World Mental Health day. We have been propagating that there is a paradigm shift the way we need to tackle mental illnesses. That depression is no more a stigma or a social issue, that depression is treatable, that depression is a manageable disease and that depression needs to be diagnosed early.
If it is a disease then why still it is not covered under mediclaim? Why would people disclose ‘depression’ when getting admitted when their whole claim can get cancelled?
We say suicidal ideation is a medical emergency and such patients needs admission. If it is not covered in mediclaim nobody will disclose or one will get admitted under the disguise of some other illness.
On one hand we want special act for mental health and on the other hand we deny their right to get treated.
1. “I have carefully looked into this. As of now there are no specific government guidelines or legislative provisions about insurance coverage of psychiatric disorders. Hence the insurance providers are not providing coverage for Depression. This is denial of justice and we must fight against it. Prof Roy Abraham Kallivayalil. Secretary General, World Psychiatric Association”
2. Travel Medical Insurance Policy Exclusions: No claim will be paid arising from suicide, attempted suicide or wilfully self-inflicted injury or illness, mental disorder, anxiety, stress of depression, alcoholism, drunkenness or the abuse of drugs.
3. The World Health Organisation has recently estimated that 1 in 4 persons will be affected by some form of mental illness once in their lifetime.
4. In 2005, it was estimated that 6-7% of the population suffered from mental disorders, and about 1-2% suffered from severe mental disorders such as schizophrenia and bipolar disorder.
5. Nearly 5% of the population suffer from common mental disorders such as depression and anxiety. This number is much higher as mental illness often goes underreported due to the associated stigma and non-coverage in mediclaim like policies.
As passed by Rajya Sabha on 8th August 2016, the new mental care health bill clause (4) every insurer shall make provision for medical insurance for treatment of mental illness on the same basis as is available for treatment of physical illness. Also under the new bill suicide has been treated as a form of severe stress which will not be punishable under 309 of IPC. But as on day the act is not applicable and depression patients are not under the coverage of mediclaim or other reimbursements.