The surge in seasonal illnesses like Dengue, Malaria, and Gastroenteritis is driving up healthcare costs, with average treatment expenses soaring to Rs 1,50,000 during peak months.
According to the latest assessment by insurance marketplace Policybazaar.com, these conditions account for a significant portion—33% to 40%—of health insurance claims linked to seasonal diseases.
Dengue and Malaria, comprising 15% of these claims, see a spike in July and August, when mosquito breeding is rampant.
Gastroenteritis, contributing 18% of claims, is prevalent throughout the year, especially during the monsoon. The financial burden is further amplified by rising treatment costs for conditions like allergies, influenza, and bronchitis, which also peak during specific seasons.
Over the past three years, the average claim size for these illnesses has escalated by 150%, with metropolitan cities like Mumbai and Delhi leading in the number of claims.
Key highlights from the Policybazaar data;
1. Dengue and Malaria
a. Account for 15% of total seasonal illnesses claims.
b. The cost of treating these mosquito-borne diseases typically ranges from Rs 50,000 to Rs 1,50,000.
c. These claims surge in July and August when warm, humid conditions create ideal breeding grounds for mosquitoes.
2. Gastroenteritis, or stomach flu
a. Contributes to 18% of seasonal claims.
b. Treatment costs for this condition range from Rs 50,000 to Rs 1,80,000.
c. Claims for gastroenteritis peak throughout the year, particularly during the monsoon season (July and August) due to the increased incidence of waterborne diseases.
3. Allergies, including seasonal allergic reactions
a. Contribute to 10% of health claims for seasonal illnesses.
b. The cost of treating allergies ranges from Rs 30,000 to Rs 90,000.
c. Claims peak during the spring and monsoon seasons, varying by region.
4. Influenza, commonly known as the flu
a. Accounts for 20% of health insurance claims during peak seasons.
b. The typical claim amount for influenza ranges from Rs 25,000 to Rs 1,00,000
c. Claims peak during November to February, when cold weather and increased indoor gatherings facilitate the spread of the virus.
5. Bronchitis
a. Represents 12% of health claims for seasonal illnesses
b. Treatment costs range from Rs 40,000 to Rs 1,20,000.
c. Claims for bronchitis are most common in the winter months, from November to February, as cold weather exacerbates respiratory conditions.
Rise in average claim size (last 3 years)
The claim size for seasonal illnesses has risen dramatically at approx 150% over the last 3 years.
Common types of medical claims for seasonal illnesses
- During seasonal illness periods, most claims (50-60%) are for prescriptions, covering medications such as antivirals and antibiotics.
- Outpatient Department (OPD) visits account for 30-40% of claims, including consultations with general physicians and specialists.
- Hospitalizations, comprising 15-20% of claims, are filed for severe cases requiring extended medical treatment or procedures.
Geographic distribution of claims
- Mumbai leads with 20% of the total seasonal illnesses claims, followed by Delhi at 18%, Bangalore at 15%, Chennai at 12%, and Hyderabad at 10%.
- This distribution highlights the higher incidence of seasonal illnesses in major metropolitan areas.
Age-wise distribution:
- Children and adolescents (<18 years): This age group accounts for 20-25% of seasonal illnesses claims, primarily due to their susceptibility to respiratory infections and allergies, especially during seasonal changes.
- Young adults (18-30 years): Representing 15-20% of seasonal illnesses claims, this group is often active and mobile, leading to exposure to various seasonal illnesses.
- Adults (30-45 years): Contributing 10-15% of seasonal illnesses claims, this age group tends to have stronger immune systems and may be less prone to severe seasonal illnesses compared to younger and older populations.
- Middle-aged adults (45-60 years): This group makes up 20-25% of seasonal illnesses claims, reflecting an increase in health issues, including susceptibility to severe cases of seasonal illnesses.
- Senior citizens (60+ years): The elderly population, who are more susceptible to severe illnesses, account for 25-30% of seasonal illnesses claims. This high percentage underscores the need for vigilant health monitoring and timely medical intervention for older adults during seasonal peaks.
The data underscores the crucial need for comprehensive health insurance to manage the growing medical expenses associated with seasonal illnesses across all age groups, particularly the elderly, who are the most vulnerable.