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Why insurers don't want to cover weight-loss surgery

September 11, 2013 15:01 IST

While there has been a rise in obesity reduction surgeries, it may still take time before health insurance cover is made available for these. 

Such surgeries come under the cosmetic surgery category, which is excluded from the purview of health insurance coverage, according to the Insurance Regulatory and Development Authority (Irda) norms.  

While the surgeons demand bariatric surgeries be kept out of the cosmetic surgery category, insurers are not comfortable covering this procedure.

Bariatric surgery involves a surgical procedure through which the size of the stomach is curtailed, leading to reduced consumption of calories. The cost of surgeries range from Rs 2 lakh to several lakhs

of rupees, depending on the exact nature of surgery. 

Practitioners point out that the surgery not only cures obesity but also its allied ailments. Dr Muffazal Lakdawala, founder of Centre for Obesity and Digestive Surgery (CODS), said most developing nations have passed regulations to ensure bariatric surgeries are provided insurance cover.

“Insurers here are not ready to provide cover for these procedures. Bariatric surgeries cannot be considered cosmetic surgeries. Customers should be given the opportunity to choose whether they want to take an insurance cover or not.”

A senior official with a private general insurance company said that most cases of bariatric surgeries are for cosmetic purposes and, hence, it is difficult to ascertain under which category does the surgery fall and if it is life-threatening.

M Saraswathy in Mumbai
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