It has been three years since the Covid-19 pandemic subsided, but more than 95,000 are still awaiting their promised insurance payouts. The government has yet to release over Rs 11.34bn in covid insurance claims, leaving many policyholders in limbo.
During the pandemic, around 1.75m policies were issued under the covid insurance scheme, with nearly 165,059 claims filed. While 69,765 policyholders have received payments totaling around Rs 6.58bn, the remaining 95,294 have received nothing. Insurance companies say that they are unable to make the payments because the government, which had promised to cover liabilities beyond a certain threshold, has not allocated the necessary funds. The Ministry of Finance, meanwhile, cites a lack of resources amid ongoing budget constraints.
“The covid insurance issue is a priority,” said Ambika Prasad Khanal, the spokesperson for the Ministry of Finance. “However, due to the pressure on resources, nothing can be said about insurance payout at the moment.” The finance ministry has failed to commit funds, despite repeated requests from both insurance companies and the Nepal Insurance Authority (NIA)—the insurance market regulator.
“Insurance companies have done what they could. The rest is up to the government,” said Nirmal Adhikari, spokesperson for the Nepal Insurance Authority. “We are mere coordinators; it is the government’s responsibility.”
Frustrated by the government's inaction, insurance companies and policyholders have taken the matter to the Supreme Court. They have filed lawsuits against both the NIA and the government. The Nepal Insurers Association, the umbrella body of 14 non-life insurance companies, has said that the government has failed to honor its financial obligations.
“We were told the government would shoulder the burden beyond Rs 3.5bn,” said Chunky Kshetri, former chairperson of the association. “But after years of waiting, we have been left with no choice but to seek justice in court.” The lack of payment has not only affected individual policyholders but also had broader implications for the insurance sector, which is grappling with reduced credibility and operational challenges.
Complicating matters further are allegations of fraud. At least 669 cases of duplicate or fraudulent claims, amounting to Rs 63.9 million in irregular payouts, have been identified. However, insurance expert Rabindra Ghimire said this was largely due to the lack of strong oversight mechanisms and clear policy limits. “Insurance fraud is common all over the world, especially in health insurance,” Ghimire said. “Here, the government did not set timeframes or caps on covid insurance payouts, unlike Thailand and Singapore, which managed expectations and liabilities from the beginning.”
Thailand and Singapore limited their coverage to small amounts and set deadlines for claims which helped prevent excessive liabilities. Nepal, however, offered up to Rs 100,000 per person with no clear claim deadlines which led to overwhelming demand and a ballooning fiscal responsibility. The covid insurance scheme was launched in April 2020 with premium rates as low as Rs 300 for coverage of Rs 50,000.
