Lok Sabha Question No. 59 (STARRED), answered on 2018-07-20
Subject: Insurance Cover for HIV Patients
Ministry: FINANCE
Asked by: MANSUKHBHAI DHANJIBHAI VASAVA, RAM TAHAL CHOUDHARY

## GOVERNMENT OF INDIA MINISTRY OF FINANCE DEPARTMENT OF FINANCIAL SERVICES

## LOK SABHA STARRED QUESTION NO. *59

TO BE ANSWERED ON 20 th  July 2018/ Ashadha 29, 1940 (Saka)

## Insurance Cover for HIV Patients

- *59.  SHRI MANSUKHBHAI DHANJIBHAI VASAVA: SHRI RAM TAHAL CHOUDHARY :

Will the Minister of FINANCE be pleased to state: (a) whether there is any clause in insurance policy under which HIV positive patients are not provided insurance cover and if so, the details thereof; (b) whether the said clause is not discriminatory for the HIV positive patients; and (c)  if  so,  the  reaction  of  the  Government  in  this  regard  and  the  action  taken  by  the

Government in this regard?

## ANSWER THE FINANCE MINISTER

## (SHRI PIYUSH GOYAL)

- (a)  to (c)   A Statement is laid on the Table of the House.
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## STATEMENT  REFERRED  TO  IN  REPLY  TO  PART  (a)  to  (c)  OF  LOK  SABHA STARRED QUESTION NO. *59 FOR 20 th  July, 2018 REGARDING 'Insurance Cover for  HIV  Patients'  TABLED  BY  SHRI  MANSUKHBHAI  DHANJIBHAI  VASAVA  and SHRI RAM TAHAL CHOUDHARY.

(a) to (c). Insurance Regulatory and Development Authority of India (IRDAI) has notified IRDAI  (Health  Insurance)  Regulations  2016  on  18 th July,  2016  to  encourage  the insurers to offer insurance coverage to various hitherto uncovered market segments like people suffering from HIV/AIDS. Some of the key provisions of these regulations are:

- (i)  Insurance  companies  shall  have  Board  approved  underwriting  policy which  shall  be  periodically  reviewed  to  cover  the  changes  affecting  the medical field.
- (ii)  The  Underwriting  policy  shall  also  cover  aspects  relating  to  substandard lives and that denial of the coverage shall be the last resort of the insurer.
- (iii)  Concept  of  pilot  product  introduced  to  encourage  insurers  to  design innovative products for covering risks that have not been offered hitherto or stand excluded in the extant products.

However,  the  product  design  is  in  the  realm  of  the  Insurance  companies  and acceptance of any risk is based on its underwriting policy. Illustratively, there are some specific insurance products that grant health insurance coverage to People Living with HIV (PLHIV) by a few companies. Details are given below:

| Name of the Insurer                     | Name of the product                  | Extent and Scope of Risk Cover                                                                                                                                                                                                                                                                                                               |
|-----------------------------------------|--------------------------------------|----------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------|
| Star Health and Allied Insurance Co Ltd | Star Net Plus                        | Minimum Sum Assured: Rs 5000 Maximum Sum Assured: Rs 50000 If the Insured person is medically declared as having reached the stage of AIDS, the Sum Assured is payable as lump sum.                                                                                                                                                          |
| Cigna TTK Health Insurance Co Ltd       | Cigna TTK Global Health Group Policy | Minimum Sum Assured: Rs 50 lacs Maximum Sum Assured: Rs 12 Crores This group insurance policy covers medical expenses that arise from or in any way relate to HIV and or HIV related expenses including AIDS. This group insurance policy covers a number of events such as New Born Cover, Psychiatric and psychological care and AIDS/HIV. |

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