Early detection of disease can save higher claims, which insurance companies are paying at present

We came across two interesting news items recently which had following information for us:

1. According to AIIMS study 90% women ask for medical help after stage 1 of breast cancer. 70% of women go to their doctors in the 3rd and 4th stages of breast cancer, by when conservation of the organ is very difficult and chances of cancer developing in the other breast are very high. Naturally it means high claim figure to be paid by insurance company as well as pain and agony for the patient.

2. As per a study published in the Journal of Clinical Endocrinology and Metabolism, people with periodontitis are at about 20% greater risk of heart attack. 34% of people with moderate periodontitis and 37% with severe periodontitis had metabolic syndrome, compared to just 18 percent of people with no gum disease or only mild periodontitis.
Metabolic syndrome is a cluster of risk factors for heart disease, paralysis and diabetes, including high blood pressure, abdominal obesity, low levels of “good” HDL cholesterol and high triglycerides (another type of blood fat).

By not covering dental treatment as a part of Health Insurance, most of the insurance companies feel that they are saving lot of money. But if they start paying for dental treatments, maybe they can save higher claims for which they are called upon to pay at a later date.

Insurance companies issue health insurance policies to individuals below the age of 45 years without any medical examination and charge appropriate premium from them. In most of the policies there is provision to pay for the health check up expenses but on the one hand amount to be paid is small and a good effort is involved in reimbursement of the same. The consequence is that most of the insured prefer to forgo the same rather than avail this facility.

From the above mentioned two instances we find that if preventive diseases are detected early, it will be beneficial for both the individual as well as the insurance company.

Some of the suggestions which insurance companies may consider:

• Create awareness and encourage females to go in for mammography test for examination of breast cancer so that it can be detected in early stages and cured easily with much less costs. Sending SMS/email or even telecalling the insured after the age of 45 years will result in good response. The insured will appreciate this gesture on part of the insurance company.


• Tie-up with dental surgeons to offer discounts to people who have health insurance policy. No outgo will happen as far as the insurance company is concerned but there will definitely more and more customers coming to Dental Surgeons and hence they will be motivated to give discount as a gesture of goodwill and low cost in getting more customers who will become customers of their clinic.