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Can I claim for Morbid Obesity treatment from my existing health insurance policy?

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29 Sep, 2020 by Harris Md

Morbid obesity is covered in existing health insurance from October 1. Can I get surgery done and claim the cost from my insurance policy. I have a health insurance from Royal Sundaram

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30 Sep, 2020
Mahavir Chopra

Hello Harris,


The revised definition of the Obesity/Weight Control exclusion will be effective on all existing and new policies from tomorrow onwards.

As per this definition, treatment that meet the following conditions will be covered going forward:

  1. Surgery advised by a doctor.
  2. Surgery follows standard clinical protocols (Usually of the doctor is adequately qualified this should not be a problem)
  3. The member should be 18 years or older.
  4. Body Mass Index should be greater than 40 or greater than 35 where the obesity is also coupled with other diseases like Coronary Heart Disease, Severe Sleep Apnea, Uncontrolled Diabetes Type 2, Obesity related cardiomyopathy.


Would recommend you show this note, to the doctor who has recommended/advised the obesity surgery - he should be able to let you know if the treatment can get paid or not.


Hope this helps. Do let us know if you have any follow up questions.


Regards,

Mahavir Chopra


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