Are Senior Citizens Not On The Priority List For Health Insurers?

Financially, seniors are a lot disadvantaged than those who are still in their working years. The loss of a regular source of income in retirement years is a major handicap that affects seniors.

Amid this, a survey by insurance aggregator SecureNow has revealed a rather disturbing trend that insurance companies on average take more days to clear the claims settlement of senior citizens. Also, insurers are less likely to entertain claims (either in full or proportion-wise) for certain diseases related to heart, genito-urinary, cancer, and digestive-related, despite the fact that seniors often pay at least six times the premium than for someone in their 30s.

“It was found that a senior citizen’s health insurance claim is typically resolved in 28 days as opposed to 23.2 for those under the age of 60. Insurers, intermediaries and hospitals must help seniors file claims fast – or opt for cashless settlement,” the survey by SecureNow reveals.

According to the survey, the health claims of senior citizens are usually settled one week later than those below 60 years of age. One possible reason is that they take more time to inform insurance companies about their illness and treatment post hospitalisations.

Insurers also take more time to settle those claims that are submitted for settlement. Also, the proportion of claim settlements for senior citizens is lower in cases of specific ailments, such as diarrhoea, cancer, and prostate enlargement, the survey revealed.

Out of a sample size of 1,250 claims, of which 576 belonged to seniors, as much as 84 per cent claims related to digestive diseases are found likely to be settled for less than what was claimed. The corresponding percentage for cancer, genito-urinary and coronary heart diseases were 73, 83 and 85 per cent, respectively, according to the survey.

As such, senior citizens should carefully evaluate their health insurance, particularly in terms of restrictions on cancer and digestive ailments treatment before buying such policies, the survey said, adding that “the likelihood of developing illnesses and being ill rises with age. Health insurance for seniors offers a variety of benefits, including coverage for severe illnesses, cashless hospitalisation, and specialised coverage for conditions like cancer, stroke, and others. Senior citizens are also required to carefully evaluate them.”

Kapil Mehta, co-founder, SecureNow says, "Senior citizens take a longer time to intimate claims to the insurers, have a higher hospitalisation stay, incur higher treatment costs, and have slightly higher insurance deductions. They also pay much more for insurance, someone aged 75 has to incur a premium six times that of someone aged 30. There is an opportunity to support seniors in selecting the right insurances and in supporting them through claims.”

Mehta added that the number of insurance products has increased significantly over the years and insurers are taking much better care of seniors’ insurances, but “more work remains to be done since seniors are extremely vulnerable”. 

He further said that it is the duty of the insurers, intermediaries and hospitals to assist senior citizens to file claims promptly in case they have not opted for cashless settlement.