Status of inclusion of mental illness under health insurance coverage in India - An exploratory study

The Mental Health Care Act, 2017 led the Insurance Regulatory and Development Authority of India to issue directives which mandated every insurer to make provisions for treatment of persons with mental illness. While many insurance companies tried to adhere to the directives, the ground reality was far from desirable.

An exploratory study was conducted with the aim of understanding the status of insurance companies toward the inclusion of mental illness under health insurance coverage in India.

The study was done in two parts: (1) review of health insurance policies and (2) interview of insurance personnels about status toward including mental illness under health insurance. The data collected from the in-depth interviews were analyzed qualitatively using thematic analysis.

Thirty-three individual health insurance policies from both nationalized and private sector insurance companies from across India were reviewed. Out of the 33, 17 policies did not explicitly mention mental illness coverage in their inclusion criteria; 14 policies explicitly mentioned mental illness coverage in their inclusion criteria, and two policies explicitly mentioned mental illness coverage in their exclusion criteria. A thematic analysis of the interviews led to three global themes: Barriers in Providing Services, Methods to Reduce Barriers, and Readiness to develop a new product for persons with mental illness.

The study helped understand the perspective of the insurance industry toward mental illness coverage under health insurance and suggested recommendations for alleviating the barriers in providing insurance services to clients with mental illness.