Less than 1% of health claims pertain to mental wellbeing, ET BFSI

Regardless of rising consciousness and rising mental health considerations, India’s insurance sector continues to fall brief in offering sufficient protection for psychological well being remedy. Lower than 1% of complete medical insurance claims in India pertain to psychological wellbeing, based on a report by Marsh McLennan, launched in collaboration with Mpower on Wednesday.

That is regardless of the Insurance coverage Regulatory and Growth Authority’s (IRDAI’s) 2018 mandate that requires psychological well being protection to be handled on par with bodily well being.

The ‘RiseUp for a Higher Tomorrow’ Psychological Well being Report 2025 highlighted the vital gaps in mental health insurance whilst office stress, lengthy working hours, and financial uncertainties have heightened psychological well being challenges.

Protection for outpatient therapy, rehabilitation, and dependancy remedies continues to be lacking from most plans, leaving people to bear excessive out-of-pocket bills, it mentioned.

Employers are struggling to bridge the hole, with 83% of organisations reporting minimal claims utilisation, and 42% of people both unaware of their psychological well being protection or missing any in any respect. Moreover, solely 17% of insured people have entry to outpatient counselling, regardless of its vital function in psychological well being remedy.

Excessive remedy prices stay a serious deterrent, with 49% of people citing monetary burden as the largest problem in looking for psychological well being care.

Office stigma additionally performs a big function, as almost half of workers concern discrimination in the event that they disclose their psychological well being circumstances, whereas a scarcity of in-network suppliers additional complicates entry, the report mentioned.

It highlighted evident regulatory gaps, notably the exclusion of dependancy remedies and rehabilitation centres from most insurance coverage insurance policies, creating further obstacles for these in want of care.

“Regardless of legislative help and fewer than 1% of claims being for psychological well being, it’s clear that the insurance coverage business has failed to supply psychological well being protection,” mentioned Sanjay Kedia, chief govt of Marsh McLennan India.

The Psychological Healthcare Act, 2017, additional supported by IRDAI, mandates each insurer to cowl psychological well being remedy, he identified.

The report known as for pressing motion from insurers, employers, and policymakers to combine outpatient psychological healthcare, similar to remedy, teleconsultations, and rehabilitation, into core insurance coverage insurance policies.

It additionally confused the significance of eliminating coverage exclusions that stop people from accessing remedy for substance use problems and self-harm-related circumstances.

The research, which surveyed 150 organisations throughout industries, underscored the necessity for systemic coverage adjustments that align India’s insurance coverage framework with international greatest practices.

Past coverage reforms, the report highlighted the significance of public consciousness campaigns to deal with stigma and educate people on psychological medical insurance advantages.