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 crucial gaps in psychological medical insurance at the same time as office stress, lengthy working hours, and financial uncertainties have heightened psychological well being challenges.
Protection for outpatient remedy, rehabilitation, and habit therapies remains to be lacking from most plans, leaving people to bear excessive out-of-pocket bills, it stated.
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 crucial function in psychological well being therapy.
Excessive therapy prices stay a serious deterrent, with 49% of people citing monetary burden as the largest problem in searching for psychological well being care.Office stigma additionally performs a major function, as practically half of staff worry discrimination in the event that they disclose their psychological well being situations, whereas an absence of in-network suppliers additional complicates entry, the report stated.It highlighted obvious regulatory gaps, notably the exclusion of habit therapies and rehabilitation centres from most insurance coverage insurance policies, creating extra 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 trade has failed to supply psychological well being protection,” stated Sanjay Kedia, chief government of Marsh McLennan India.
The Psychological Healthcare Act, 2017, additional supported by IRDAI, mandates each insurer to cowl psychological well being therapy, he identified.
The report referred to as for pressing motion from insurers, employers, and policymakers to combine outpatient psychological healthcare, akin to remedy, teleconsultations, and rehabilitation, into core insurance coverage insurance policies.
It additionally burdened the significance of eliminating coverage exclusions that forestall people from accessing therapy for substance use problems and self-harm-related situations.
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 handle stigma and educate people on psychological medical insurance advantages.