Thiruvananthapuram: Insurance companies are increasingly denying medical claims by citing patients’ mental health treatment histories, sparking outrage and renewed stigma around psychiatric care. Claims for unrelated procedures like cataract or heart surgeries are being rejected based on previous treatments for depression or obsessive-compulsive disorder (OCD).
The issue gained public attention after actor Archana Kavi shared her struggles with claim denial, highlighting a rising wave of complaints from patients at hospitals known for mental health services. Despite the Mental Healthcare Act, 2017, mandating equal treatment for mental and physical illnesses, insurance companies continue to discriminate.
Ajinas, a resident of Ernakulam, recounted his frustration when his mother’s cataract surgery claim was rejected. “The insurance company asked about her depression history, which had no connection to the surgery, and denied the claim. It feels like a deliberate attempt to avoid covering legitimate costs,” he said.
Vivek Raj from Alappuzha faced a similar ordeal when his claim was refused due to a history of bipolar disorder. Despite escalating the issue to the Insurance Regulatory and Development Authority of India (IRDAI), he received no resolution.
Experts have criticized insurers’ tactics, including policies that require proof of at least 40% mental health disability for coverage eligibility. “This criterion creates unnecessary hurdles for patients with stabilised conditions like OCD or depression, defeating the Mental Healthcare Act’s purpose,” said Dr. C.J. John, senior psychiatrist and member of the State Mental Health Authority.
The inconsistent implementation of mental health coverage, mandated by IRDAI in 2022, underscores the need for stricter regulation to protect patients’ rights.
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