Among all major cities in India, Bengaluru has been the most transparent in terms of COVID-19 data reporting, according to a recent analysis of registered health insurance claims done by Jeevan Raksha, an initiative of management consulting firm Proxima Consulting and non-profit organisation Public Health Foundation of India (PHFI). As per the General Insurance Council data, in July alone, 33,241 new health insurance claims (non-government schemes) were registered for COVID-19 treatment in six megacities — Ahmedabad, Bengaluru, Chennai, Delhi, Kolkata, and Mumbai. According to official statistics, a total of 36,688 persons were infected across these cities in July.
These figures suggest that about 91% of these infected persons had insurance cover. However, the Insurance Regulatory and Development Authority (IRDA), under the Ministry of Finance, estimates only 3% of India's population to be covered under group or individual health insurances (non-government schemes like Ayushman Bharat Pradhan Mantri Jan Arogya Yojana).
The analysis found that in Bengaluru, insurance claims were made for 4,991 (36%) cases when the official tally was 13,780 cases. In contrast, Ahmedabad, which had officially reported 283 cases in July, had 5,009 (1770%) insurance claims.
Even though the number of people having health insurance is higher in metro cities, the underreporting is significant. The proportion of COVID-19 patients having health insurance cover (excluding government schemes) to the total COVID-19 patient should be in line with the percentage of health insurance to the total population of the state, the study said. “However, as per the health Insurance claim report for July, approximately nine out of 10 COVID-19 patients in these megacities had health insurance cover, which is illogical. The primary reason for the huge variation is massive underreporting of cases and deaths,” it noted.
For July alone, the data suggest that five lakh cases and 10,000 deaths are estimated to be underreported in the country. “The six megacities, which contribute nearly one in every five cases and deaths, might have underreported to the tune of 1.8-2 lakh cases and 2,200-2,500 COVID-19 deaths,” the analysis said.
After Bengaluru, Mumbai fared second in terms of being transparent about reporting COVID-19 cases. Out of the estimated underreporting of 1.8 lakh COVID-19 cases, Delhi is estimated to have underreported about 60,000 cases and approximately 1,000 deaths; Ahmedabad about 33,000 cases and 500 deaths; and Chennai about 30,000 cases and 300 deaths.
Similarly, 15% of all COVID-19 deaths in Bengaluru in July had received insurance claims. In Ahmedabad, however, there were 81 insurance claims for eight deaths due to COVID-19.
“Bengaluru Urban has been relatively the most transparent megacity with respect to COVID-19 data disclosures. It is the only megacity that issues a comprehensive daily bulletin, independent of the state COVID-19 bulletin and continues to disclose daily testing data and other crucial data with the general public,” the analysts said.
“In July, the insurance claims for COVID-19 death to total COVID-19 deaths in Bengaluru Urban is by and large (in line) with the percentage of population covered with health insurance, taken by a group or individuals to cover for themselves and their family members. This validates that there are limited traces of under-reporting of COVID-19 deaths in Bengaluru Urban,” said the study.
It also noted that one-fourth of the health insurance policy-holders in India are in Maharashtra. “Therefore, 6% of the Maharashtra population is covered with group and Individual Health Insurance (excluding government schemes). Therefore, there is a high degree of correlation between total COVID-19 cases and deaths, and the insurance claim ratio. Thus, underreporting in Mumbai is relatively bare minimal,” it added.
The study noted that if state governments underreport cases and deaths, it will give a temporary delusory satisfaction, which eventually “surge into a tsunami as experienced in the peak of the second wave.”