HEALTH INSURANCE COVER DENIED TO ALTRUISTIC A KIDNEY DONOR

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HEALTH INSURANCE DILEMMA OF ALTRUISTIC KIDNEY DONOR

Dr. Ravi Wankhede

My wife and self were covered for hospitalization expenses with the New India Assurance Company for about two decades. On attaining the age of 65 years, the Insurance policy ended about two years ago. I had not availed any claim for myself during the period. I came to know that the government has extended the Insurance cover for citizens above the age of 65. On my financial consultant’s advice, representatives of Religare Health Insurance Company Limited called on me. I gave all my details, including no history of any sickness. I told them that I had donated a kidney to my friend in 2009 and was not having any complaints whatsoever. I asked the representatives, whether donation of kidney will have any negative impact on my proposal. I was told that my medical examination with laboratory tests would be carried out and if any major contraindications were detected the proposal would be rejected. I paid the premium. Within a fortnight I got an email that the proposal was rejected as per guided by our underwriting policy that endeavors to group individuals who exhibit homogenous risk profiles. It is in no way an indicator of your past, present or future state of health. I wrote to the Religare Health Insurance Company Limited wanting to know what exactly was the meaning of homogenous risk profile. The RHICL did not elaborate on the condition.

After sometimes I applied online to Cigna TTK Health Insurance Company. There were several rounds of telephone conversations which according to the company, recorded for future reference. As earlier, I informed about my kidney donation, including keeping absolutely perfect health. Because of my past experience, I gave a lot of stress and asked whether kidney donation was a deterrent to get the health policy. I was told all the time, that my medical examination and investigations would be carried out and if anything abnormal was found, the proposal would be decided by the Company. I paid the premium of over lac rupees. Here again I got an email informing "We regret to inform you that we are unable to provide you with the insurance cover applied in view of personal medical history of organ donation… This decision is purely on the basis of an underwriting risk assessment done by the company and is not a recommendation on your health status.” I wrote to the CignaTTK customer services at all levels to redress my grievance as to why my proposal was accepted if it was known that I was a kidney and in that an altruistic donor. Also no medical examination and investigations were not carried out as was informed to me earlier. I wrote to them that one kidney was sufficient to live a normal life and they could check it with the medical advisors of the company. I wrote to them that Insurance pays for kidney donors hospital expenses. One afternoon, I got a telephonic call from the office of Cigna TTK and we spoke at length and exchanged our views. The person assured me that I would get a reply very soon. I have not heard anything from their office so far.

The Country Director of MOHAN Foundation Mrs. Lalitha Raghuram took pains to talk to Mrs. Yegnaprabha Bharat the Joint Director of IRDAI and apprised her of the my case. Mrs. Bharat told her that “all live donors ARE given Insurance, and there has been no exception to this”. I was asked to make a complaint to the IRDAI, which I have done recently. I have not heard anything from IRDAI as well as Cigna TTK. My dilemma is, what happens if ever, I will require hospitalization (unless I die in my sleep) for a major ailment in my senescent years which is unavoidable. Looking of late at the huge hospital expenses, I will have to shell out major part of my savings which is basically meant to help myself and my wife in our age.