‘Middle class struggles to apply for mental health insurance’

New Delhi: “During the pandemic, with the negative effects of the recession and substance use disorders on the rise, the importance of mental health has also increased. According to multiple reports, approximately 10.6% of adults in India will suffer from some form of Mental Illness. The 2017 Mental Health Care Act came into force in 2018, with amendments to legalize attempted suicide, which had previously been punished under Section 309 of the Indian Penal Code. However, brokers who deal with various insurance companies in India People continue to break the rules, denying policyholders’ claims on various grounds. On the other hand, most insurance companies do not understand the provisions of the Act and their rights.
Interestingly, some public insurers, such as the National Insurance Company and the Oriental Insurance Company, started including mental illness in their policies during the pandemic and only paid out hospital or insurance companies when a patient was hospitalized. Any type of counseling, cognitive behavioral therapy, or psychotherapy that does not require hospitalization is clearly stated in their policy as excluded. For National Insurance Company Limited, Alzheimer’s disease, Alzheimer’s dementia and Parkinson’s disease are permanently excluded if the policy is purchased.
“Many people don’t know that in order to apply for insurance, patients need to be hospitalized for at least 24 hours. Also, in most cases, banks deny claims because their health conditions are related to some pre-existing conditions. Therefore, only after purchasing insurance You have to be diagnosed with a new condition before you can apply for insurance,” an insurance broker, who asked not to be named, told the Sunday Guardian.
He also added: “Insurance is really a for-profit business, as many brokers convince people to have health insurance in multiple places. On the other hand, they make people believe that they can withdraw money from two places, however, this is completely It’s illegal. Many people sometimes create fake hospital bills and foolishly try to claim their money from two places. Since everything is online now, their details can be tracked and then their claim will be denied.”
Mental illness requires not only medication but also rehabilitation, psychotherapy and counseling, all of which can put families in financial distress. Pre-existing medical problems attract additional fees from insurance companies. So one company, Tatsam, is developing a one-of-a-kind mental health service with a focus on working professionals. With the help of counseling and clinical psychologist training and mentoring programs, the company will create a scientifically sound, evidence-based mobile mental health app that can be used alongside traditional therapies. When it comes to mental health, Tatsam CEO Deepak Singh told this article, “Our main goal is to help people understand that mental health is as important as physical health. Just like our physical health, if we don’t Committed to mental health, we will face problems caused by unhealthy mental health. The product contains three main solutions – a program to build long-term mental health, an immediate relief program to help people in real time, and a personalized An exceptional network of trained, certified care providers.” Currently, the company’s goal is to examine the efficacy of smartphone-based therapy combined with traditional therapy for three psychological disorders with significant global prevalence: depression Disorders, Anxiety Disorders and Emotional Disorders. Data collection aimed at eventually running RCTs on apps to assess efficacy and client response, as finding quality, evidence-based apps remains a daunting task.
Throughout the history of mental health insurance, India introduced Ayushman Bharat PM-JAY in 2018, which covers pre- and post-hospitalization for mental disorders such as mental retardation, organic mental disorders (including symptomatic schizophrenia, schizophrenia) Cost of treatment and delusional disorders, neuroses, stress-related and somatoform disorders, emotional (affective) disorders, behavioral syndromes related to physical and physical factors, mental and behavioral disorders caused by psychoactive substance use. However, obtaining mental health insurance remains a challenge for the middle class due to the high cost of pre-diagnosed treatment.

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