Rejection of insurance claims for antibody cocktail rise – The Hindu BusinessLine

Clipped from: https://www.thehindubusinessline.com/money-and-banking/rejections-of-insurance-claims-for-antibody-cocktail-rise/article38177930.ece

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Amid greater demand for the treatment, experts caution against its overuse

Even as the number of Covid-19 cases witness a steep rise in the wake of the new variant Omicron, there has been a steady rise in demand for monoclonal antibody cocktail therapy. While insurance companies say they have been honouring the claims arising out of this line of treatment, hospitals say there has been rise in rejections as insurers say it is experimental drug therapy.

According to Dr S Prakash, Managing Director, Star Health and Allied Insurance, the cocktail antibody therapy was considered effective against the Delta variant. However, experts have expressed their apprehensions regarding the efficacy of the treatment for the Omicron variant.

“We should be very careful and any abuse of such cocktail antibody should be avoided,” Prakash told BusinessLine.

Rise in demand

Hospitals across Kolkata confirm that with the upsurge in the number of cases, there has been a rise in demand for antibody cocktail therapy as compared to the second wave caused by the Delta variant.

“Typically, 10 per cent of the total number of patients admitted for Covid are administered this therapy at early stage of onset of symptoms before they start witnessing a decline in oxygen saturation levels,” said Dr Aviral Roy, Consultant – Critical Care, Medica Superspecialty Hospital.

Fewer hospitalisations

However, with the Omicron variant, it may not be as effective, Roy said, and added that there has been rise in rejections on the ground of experimental drug therapy.

Since Omicron is still considered to be milder and is not as virulent as the Delta variant, the need for hospitalisation might be lower. If there is no hospitalisation, then insurance companies may not want to honour claims, said P Nandgopal, Founder and CEO, Insurance Inbox.

‘IRDAI directives followed’

“As per the IRDAI directive, all approved Covid treatments are covered under insurance and we pay the claims. However, hospitals should not push the therapy to people who may not need it,” said Sanjay Datta, Chief – Underwriting, Claims & Reinsurance, ICICI Lombard General Insurance.

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