WHO defines mental health as mental well-being in which an individual realizes their own abilities, can cope with normal stresses of life, can work productively and is able to make a contribution to their community. In simpler terms, it is that state in which stress is dealt with without feeling the urge to term it as “stress.” It is the foundation for individual well-being and effective functioning of a community. This type of health is of importance as it affects productivity, decision making, peace of mind and the overall personality of an individual.
It has been observed that biological reasons for poor mental health could be due to injuries, infections linked to the brain, or hereditary.
There are various stereotypes related to mental health like, mental illness occurs to those who are mentally weak or due to spirits, or that preventive measures are unlikely to succeed and that such an illness is irreversible and may lead to therapeutic nihilism.
There has been an active call amongst the people for understanding the factors and importance of mental health lately. As per a WHO report, every one out of three people have depression.
The Insurance Regulatory and Development Authority of India (IRDAI) has declared that even mental health is now a part of insurance policies. This mandatory coverage means that insurers will have to consider both mental and physical illnesses, both in the old as well as new policies. This means that the insured will be covered for hospitalization expenses for treatments of mental illnesses too. It further says “all mental illnesses such as dementia, depression and bipolar disorder shall be covered unless some specific exclusions have been mentioned in the policy”
With such a change coming our way, there will also be a change in insurance premiums. Since the act was just introduced last year, most of the insurers are yet to incorporate them into their policies. Only after all necessary changes are made, can one be sure of their future plans. It would lead to an increase in insurance premiums.
It becomes a must to be aware of the distinction in these policies. These policies and plans can be of two types:
1. The plans covering any sort of mental retardation, and
2. Outcomes of abuse of drugs or alcohol.
The new policies have been implemented since 1st November, 2022. Insurers can no longer simply reject new policy applications of people with mental illness. While new policyholders can expect these changes to benefit them, the old customers suffering from such illnesses can get a policy now. And if someone develops these illnesses after policy purchase, they are eligible to make a claim.
In case of a newborn baby, all mental illnesses that are mandatorily covered by rules will be applicable, except those of mental retardation since it is excluded from mandatory coverage as per the Mental Health Act. For the illnesses, a few policies cover the newborn from day 1, while others do so after 90 days of birth.
Most health insurance coverage works only when 24 hours of hospitalization is needed. These policies will cover any mental illness where hospitalization is needed. However, there are many new insurance policies that offer OPD coverage. If the customer has purchased an OPD cover, then the cost towards doctor consultations, diagnostic tests, etc., shall also be provided by the insurer.
Mental Health is mostly not considered a taboo topic in the recent times. Increasing awareness has given rise to wider acceptance. However, the policy features may still vary from plan to plan and company to company.
Written by Shreya Shroff
Edited by Labdhi Shah