Health cover may become cheaper for women

Health insurance for women could get cheaper considering that insurance companies view them healthier than men. Statistics of insurance claims show that women are healthier than men but they end up paying the same price for health cover as Indian companies do not practice gender-based pricing. Besides, how much women will pay in future for health cover will depend on whether insurance companies cover maternity under mainstream policies. 

"Most men with health insurance policies are professionals and end up with a more sedentary lifestyle and are, therefore, more prone to be afflicted by these kind of (lifestyle) diseases," said Sanjay Datta, head of claims and underwriting at ICICI Lombard General Insurance, the largest private sector health insurer. The company has done an analysis of its claims which shows that men's illnesses are strongly linked to lifestyle issues such as "stress, long work hours, smoking, drinking" and women's diseases are linked to neglect, weight gain and reproductive issues

"As of now, we have not inculcated this in finer pricing. But it does have an impact in pricing of family policies," said Datta. According to Datta, most of ICICI Lombard's policies have started incorporating maternity benefits, which add to claims. "Although maternity is not an ailment, there is an element of certainty in it. Though it pushes up costs we cover it because customers find benefit in the product," said Datta. He said the decision to incorporate maternity was to encourage people to buy the cover. "Nobody wants to use a mediclaim policy but when someone holds a policy for 10 years and there is no claim there is a feeling on the back of his mind that it is not utilized," he said. 

"In general, women are better risks then men although there are some conditions peculiar to women in the 45-55 age band," said Segar Sampathkumar, general manager, New India Assurance, the largest insurer in India. Sampathkumar said maternity risks are still excluded but they are being increasingly covered under group policies by employers. "In some group policies, which do not include coverage of employee's parents, maternity claims account for almost 60% of claims costs," he said. 

According to Sampathkumar, there are downsides to covering maternity in health insurance policies. "If this cover is included in standard policies, the pricing will go up for all. Also since this is not an unforeseen event, it will be possible for people to plan and buy the cover," he said. Other insurance companies also say that their analysis shows that incidence of Caesarean deliveries is higher among the insured than in the general population. 

According to ICICI Lombard's data, women accounted for only 44% of total claims. Claims for injuries are more for men at 11.5% in contrast to women at 6.8% of all claims. Similarly, in claims related to the circulatory system (including heart-related claims) the ratio is 9.3% of total claims for men and 5.2% in women. Women are more afflicted by genitourinary ailments with 13.4% claims under this segment as compared to 9.5% for males

Overall, the highest number of claims for women is on account of treatment for different types of infections.

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