AP government to launch a new health insurance scheme for all
From 1st January, 2017, the Andhra Pradesh government will be the first to provide health protection for every family in the state with its new health insurance scheme named Andariki Aarogyam. Under this new government scheme (worth Rs.160.56 crores), each family has to pay only Rs.100 per month to avail its benefits. This scheme is not mandatory for all. Previously, Swastya Vidya Vahini was launched at 222 locations across the state. Likewise, around 4 crore people are receiving 1,044 types of medical services under the NTR Medical Service Scheme, and about 16.13 lakh State Government employees and journalists are receiving 1,885 types of medical services free of cost.
30th December 2016
Liberty Videocon General Insurance launches Health Connect Supra
On 22nd December, Liberty Videocon General Insurance launched Health Connect Supra, a super top-up health insurance plan which provides additional coverage of up to Rs.1 crore. This health insurance offers emergency worldwide cover, multiple tenure period, additional discounts, and uninterrupted covers. This product was designed for self-employed individuals in Tier 2, and Tier 3 cities across the country. Liberty Videocon aims to increase its health portfolio to Rs.100 crores from Rs.20 crores. Customers can opt for an individual cover or a family floater cover. With family cover, customers can will get a family discount. Under section 80D of the Income Tax Act, customers can avail tax savings with this health insurance policy.
29th December 2016
Assam government launches the Atal-Amrit Abhiyan scheme
On 25th December, the Assam government launched a health insurance scheme called Atal-Amrit Abhiyan, to mark the 92nd birthday of the former PM Atal Bihari Vajpayee. Families with annual income below Rs.5 lakhs are eligible for the scheme. The insurance will offer coverage against 437 illnesses under 6 categories. Reportedly, this health care initiative, costing Rs.200 crores, is the biggest health care initiative taken by any State Government. The government will set-up a separate division under the Department of Health and Family Welfare for administration of the Atal-Amrit Abhiyan scheme.
28th December 2016
Highest Health Insurance Premium Collections Recorded In the Last 5 Years
According to a report released by IRDAI, health insurance companies have collected a total of Rs.24,448 crore in premium in the year 2015-2016 which is the highest amount of premium collected in the last five years. They witnessed a 21.7% hike in premium collection than the previous year. During this period, the total number of Indians covered by health insurance was 35.90 crore which is 24% higher than the previous year. These figures include statistics from the Rashtriya Swasthya Bima Yojana (RSBY) scheme, which is targeted to offer health insurance to migrant workers in India. This scheme is active in 398 districts in 19 states in India with about 4.13 families enrolled in it. MD and CEO of Max Bupa Health Insurance, Ashish Mehrotra, stated that health insurance is one of the growing sectors in India and is expected to touch Rs.50,000 crore by 2020.
27th December 2016
Uttar Pradesh CM Akilesh Yadav adds 75 lakh more families to health cover
With the state assembly elections in sight and in an attempt to aid the rural and underprivileged, the Uttar Pradesh government is all set to roll out the Mukhyamantri Swastha Bima Yojana health insurance scheme. Drafted by the State Agency for Comprehensive Health Insurance (SACHI), the scheme is expected to cover at least 75 lakh families. The health insurance which has a coverage of Rs.30,000 per year, covers four prime categories - Home guards, artisans in the Firozabad glass work factories, all contractual staff in the health sector, and construction workers. Apart from this, senior citizens get a separate health insurance cover of Rs.30,000. Any policyholder under this scheme can access facilities across 700 government hospitals and 800 private hospitals for 1000 plus medical needs that are specified in the scheme.
26th December 2016
82% of Middle-Income Group Indians Do Not Have Health Insurance
According to a recent survey conducted by BigDecisions, 82% of the middle class Indians do not have an active health insurance. Only 17.8% of people have health insurance which is inadequate to meet the potential medical expenses. The survey concludes that about 33% of the urban population is not insured up to the mark. People who have health insurance have basic health cover which will meet less than 67% of their potential medical bills. Poor health insurance cover means paying medical bills from one’s own pocket.
The survey further states that the number of health insurance claims received are way less than the actual medical treatment costs, which means that many are paying their medical bills themselves. Inflation could be a major reason for health care to be expensive in India. During 2011-2016, treatment for communicable diseases has increased by 9.3% p.a and treatment for circulatory system related diseases has increased by 2-13% p.a depending on the geography which has increased hospital bills for the urban public.
23rd December 2016
Survey reveals a 14 fold rise in the number of people opting for health insurance plans
The number of Indians covered under health insurance schemes has increased 14 times in the last twelve years, especially from 2004 to 2014. The report was published by Brookings India, after examining the survey data collected by NSSO during the said period. It also revealed that the number of people having access to any of the insurance products was below 1% in 2004, which came to around 15% by 2014. According to World Bank, more than a quarter of Indian population was covered under health insurance plans by the year 2010.
23rd December 2016
Government to soon offer social security cover to volunteers of its flagship schemes
Government plans to offer social security cover to more than one crore volunteers of its flagship schemes such as National Rural Health Mission, Integrated Child Development Scheme, Mid-Day Meal, etc. Initially, the volunteers will be eligible for provident fund and then will eventually be covered under health insurance. This move will primarily benefit anganwadi workers, ASHA workers, social health activists, and other minimum wage workers who are often not enrolled under retirement or medical insurance plans. At present, the volunteers of these schemes are entitled only for honorarium which is much below the the minimum wage allowed for government employees.
22nd December 2016
Andhra Pradesh and Telangana not among the top contributors in Health Insurance
The twin states Telangana and Andhra Pradesh haven’t made it to the list of top Indian states contributing in the Health insurance sector of the country. Based on an IRDA report, Maharashtra, Tamil Nadu, Karnataka, Delhi, and Gujarat are the chief contributors with a total premium sales of 69%. The remaining 31% of sales were reported from rest of the states including Andhra Pradesh and Telangana. For the year 2015-16, Maharashtra alone has made contributions of Rs.7,715 crores which is five times higher than the figures projected by the North Eastern states of India.
On the whole, the premium collection in health insurance sector has witnessed a sharp rise from the previous year’s sales, marking a growth percentage of 21.30%. On the other hand, life insurance segment too has recorded a significant growth in terms of the number of policies sold, when compared to the previous fiscal year. The number of claim settlements for the year 2015-16 was Rs.12,636 crores, with LIC ranking on top in claim settlement ratio. In the non-life insurance segment, Motor insurance stood on top with 43.89% contributions.
22nd December 2016
Vakrangee Ltd and HDFC ERGO tie-up to distribute general insurance products
India's largest network of technology driven retail points-of-sale, Vakrangee Limited is entering into a corporate agency agreement with a leading private sector non-life insurance company, HDFC ERGO for the distribution of general insurance products. With this tie-up, HDFC ERGO will get a distribution network of more than 26,000 outlets including areas currently not served or underserved, while Vakrangee will have the added range of quality products to distribute.
HDFC ERGO General Insurance Company is a 51:49 joint venture between HDFC Ltd, and ERGO International AG. The company offers a complete range of general insurance products, from motor, health, travel, home, and personal accident in the retail space to customised products like property, marine, and liability insurance in corporate space. HDFC ERGO has 108 branches spread across 89 cities with over 2,000 employees.
21st December 2016
Health insurance predicted to grow at a CAGR of over 20% over the next four years
A push by Prime Minister Narendra Modi, who has promoted health insurances through various savings schemes, Sanjay Datta, Chief – Underwriting, Reinsurance and Claims, ICICI Lombard General Insurance, says that health insurance is expected to grow at a CAGR of over 20% till 2020. Sanjay Dutta credits the increase use of health insurances as a consequence of the people’s awareness of the necessity of having a health insurance in the case of hospitalization and so on. He added that the industry has seen a 20% growth in 2016-2017.
20th December 2016
More States to adopt the Cashless Health Card Model of Jharkhand
The ‘Cashless Health Card Scheme’ launched by the advocates association of Jharkhand in tie-up with the Bank of India, is gaining wide acceptance among the lawyers of the state. The scheme is applicable only for lawyers and their dependents. Family members of advocates falling in the age group of 3 months to 65 years are covered under this health insurance package of Rs.1 lakh. At present, the scheme is open only to the lawyers practicing in the Jharkhand High Court. The same model of health insurance is expected to be replicated in Bihar and Chhattisgarh as well.
19th December 2016
Cyclone Vardah: ICICI Lombard Expects Claims Settlement Figures to Cross 600
Speaking to the migrants at the Technopark campus in Kerala, Labour Minister T.P. Ramakrishnan, ensured all migrants that they would receive the same treatment as kerala-born citizens. The minister has offered health insurances for migrant workers worth Rs.15,000 of free medical care and Rs.50,000 for the insurance nominee in the case of death. Ramakrishnan ensured that the whole premium will be covered by the government and the health insurance will be in association with the Local Self Government department. Apart from health insurance, the government has even constructed hostels for migrant workersICICI Lombard, one of the leading insurers in the non-life insurance segment said in a statement that they expect around 600 claims following the cyclone Vardah. However, the company also predicts the claim settlement numbers to be less when compared to previous year’s figures. The company expects more than 400 claims purely from motor insurances and the remaining from property and marine insurance. The company has sent out a team to the disaster affected areas of the city to expedite the claim settlement process. Health Care also forms a major part of the company’s portfolio of offerings, with 70 percent of the healthcare infrastructure spread out in all major cities. According to the Sanjay Datta, Chief of the company’s Claim Settlements department, health insurance is progressing at a rate of 28% per year. to make them feel welcomed and secure in the state.
19th December 2016
Kerala government offers health insurance for migrant workers
Speaking to the migrants at the Technopark campus in Kerala, Labour Minister T.P. Ramakrishnan, ensured all migrants that they would receive the same treatment as kerala-born citizens. The minister has offered health insurances for migrant workers worth Rs.15,000 of free medical care and Rs.50,000 for the insurance nominee in the case of death. Ramakrishnan ensured that the whole premium will be covered by the government and the health insurance will be in association with the Local Self Government department. Apart from health insurance, the government has even constructed hostels for migrant workers to make them feel welcomed and secure in the state.
16th December 2016
IRDAI to incentivise, make discounts in order to make health insurance universal
In a bid to lure the citizens of India into buying health insurances, the IRDAI is looking at tactics such as offering health discounts for check-ups and offering them incentives. At the FICCI's Annual Health Conference, IRDAI Chairman, Vijayan, says that for people who are risk averse, offering them free health checkups and discounts will convince them to buy health insurances, thereby eventually making it global. Reflecting on the present situation, The New India Assurance CMD G Srinivasan, says that health insurance in India lacks sustainability and isn’t accessible to all.
15th December 2016
Government offers health cover for ayurvedic hospital patients
The Rajya Sabha announced that patients seeking treatment at ayurvedic hospitals affiliated to the National Accreditation Board for Hospitals and Healthcare Providers (NABH) or registered with the government are now eligible for health cover. The announcement comes with a specification of 20 different types of ailments that will be included in the health insurance scheme. Apart from this, the guideline listed the costs of such ailments - costs coverage that will be used as a benchmark for insurance claims. The announcement came to light following the meeting between the Insurance Regulatory and Development Authority (IRDA), insurance companies and the Ayurvedic Hospitals Association.
14th December 2016
Aditya Birla Health Insurance Aims To Gain 8-10% Market Share
Aditya Birla Health Insurance, established as a partnership between South Africa based MMI Holdings Ltd. and Aditya Birla Group, is aiming to cinching nearly 8% to 10% of India’s health insurance market within the coming 4 to 5 years.
Mr. Mayank Bathwal, CEO of HDFC Life said that the insurer is looking to expand the already existing market size of Rs 27,000 crore and aiming to gain nearly 8 to 10% of the total market share in the coming 4 to 5 years. Mr. Bathwal also said that HDFC is targeting to become one of the top 5 health insurance providers in the country by the next 5 years and are looking to employ a multi-channel distribution system across bancassurance, broking, online channel agency and direct marketing. HDFC is looking to extend their services to 100 more cities in the coming 2 – 3 years.
14th December 2016
Andhra Pradesh State Government launches Swasth Kutumbam Yojana
A new health insurance scheme, named Swasth Kutumbam Yojana, was launched by the Andhra Pradesh State Government for the benefit of the Vijayawada parliamentary constituency. 265 village panchayats in the state fall under this scheme. As per this health insurance plan, every family in the district can avail treatment for an amount up to Rs.1 lakh at a corporate hospital. 60 corporate hospitals will be extending this health scheme to the village.
Medical facilities that come under the coverage of this plan include treatment for malaria, dengue, and other such diseases. Health cards will be issued under this scheme by Tata Trusts, and these cards can be used in select hospitals in the constituencies of Mylavaram, Jaggaiahpeta, and Tiruvuru. Beneficiaries can also renew their health cards on an annual basis. The insured will have to pay Re.1 per day to benefit from this scheme.
8th December 2016
Increased insurance coverage does not reduce catastrophic health spending
A study has revealed that the increase in insurance coverage among Indians has not led to reduced catastrophic health spending or a decrease in the numbers of those adversely affected by medical expenditure. These two factors are the two prime objectives of a health insurance policy. When the percentage of insured population in urban and rural India rose from 1% to 15% between 2004 and 2014, there have been a significant increase in catastrophic health expenditures. This was published in a report based on a study of health expenses by Brookings India.
Catastrophic health expenditure is the situation where families utilise more than a certain part of their income on household spending. The study took into account three thresholds, i.e., 15%, 25%, and 40%, and the results were similar in each case. It has been observed that the percentage of Indian households that were plunged into poverty due to health expenses have been 7% over the last 10 years. The report also noted a disheartening trend, i.e., out-of-pocket spending in the rural areas by the rich has been constant, while that by the poorest section has increased by 77%, in spite of many health insurance schemes targeted at them.
7th December 2016
Star Health Now Allows Agents to Solicit Instant Policies
Star Health and Allied Insurance Company agents will now be able to instantly solicit health insurance policies instantly after logging into their revamped agents’ portal. The agents can log in to the portal and choose the health insurance plan best suited to the customer, after which the customer will receive a proposal form through email. If the customer wishes to buy the policy, he/she can fill in the form and pay online, with the policy being accepted instantly subject to underwriting.
This makes it much easier for agents, who had to make multiple trips to the homes of customers to collect documents and complete other formalities. With the new portal, however, they can perform all these tasks as well as verify the information submitted by the customer online.
2nd December 2016
New India Assurance introduces 1 crore health insurance scheme
Prominent public sector insurer New India Assurance Company Ltd. has unveiled a health insurance scheme targeted at high net-worth individuals. The policy is notable in the fact that it offers a sum insured of Rs.1 crore to the policyholder. The plan is awaiting approval from the IRDAI for launch.
Additionally, the company has also modified its Mediclaim 2012 product to remove anomalies and enhance the coverage. The improved product is also under scrutiny by the IRDAI, and will be launched once an approval is obtained.
The company has set a target of Rs.21,000 crore as income through premium this financial year. This is significantly higher than their collection of Rs.18,431 crore in 2015-16. The statistics till 30th October indicate that the company has already collected premium worth Rs.13,000 crore, an increase of 25% in collections when compared to the same time last year. New India Assurance Company Ltd. has a market share of 17% and a claim settlement rate of 96%. The company stated that demonetisation had an impact on the sale of insurance initially, but the business is getting back to normal now.
1st December 2016
Kerala State Government plans for Universal Health Insurance
Health Minister of Kerala, Shylaja Teacher, stated that the government is planning to launch a universal health insurance plan with a cap of Rs.2 lakh provision to each patient. The government aims to get 50% of the state’s population equipped with this insurance. The minister was addressing the gathering at the launch of Kanivu, a charitable society for cancer, at the Regional Cancer Centre in Trivandrum.
The minister also stressed on the need for research in the field of cancer, and the necessity for waste management and pesticide control in agriculture. The Kanivu cancer charitable society was formed to address the needs of cancer patients travelling to RCC for treatment. Some of the needs that will be handled by Kanivu includes travel expenses, accommodation, and food. The centre also intends to provide counselling and rehabilitation to cancer patients and survivors, respectively.
30th November 2016
IRDAI forms committee to finalise order of preference for reinsurance cessions
The Insurance Regulatory and Development Authority of India has formed a committee to finalise the order of preference for reinsurance cessions. The committee will include representatives from the industries of life, health, and general insurance, as well as officials from prominent insurance companies.
The committee will also chart the guidelines for the implementation of the process, and this is inclusive of the delegation of responsibilities to all stakeholders. It also plans to decide timelines for the offer of best terms, in the order of preference. The committee plans to come to a conclusion and release a draft report for the same by December 9, 2016.
29th November 2016
The launch of Aditya Birla Health Insurance
Aditya Birla Financial Services Group has entered into an agreement with South Africa’s MMI Holdings Ltd. to launch their joint venture, Aditya Birla Health Insurance. The company will make an investment of Rs.250 crore initially. While Aditya Birla Financial Services Group plans to hold 51% stakes in the company, MMI Holdings will take over the rest. Aditya Birla Nuvo and MMI Holdings had signed an agreement regarding the joint venture in June last year.
CEO of the newly formed health insurance company, Mayank Bathwal mentioned that the health insurance business will have nine branches across seven cities in the country. The company also expects to utilise online channels, banks, and brokers to improve their penetration. Additionally, they plan to expand their reach to 100 cities by next year. The company’s rationale for the joint-venture is indicated as the under-penetration of health insurance in India. This is primarily due to the fact that people prefer to opt for corporate coverage as opposed to a comprehensive individual health insurance cover.
28th November 2016
Medication costs in health insurance plans
The Insurance Regulatory and Development Authority of India (IRDA) has some set guidelines on the inclusion of medication expenses in health insurance plans. Based on the terms and conditions of the product purchased, cost of drugs and medicines may be included under the cover for hospitalisation expenses. Wherever there is a clause that suggests that the product covers pre-hospitalisation and post-hospitalisation costs, medication costs are usually allowed. Some products also offer coverage for expenses incurred through outpatient procedures.
The Government’s health insurance plan, Rashtriya Swasthya Bima Yojana (RSBY), offers coverage for medical costs and hospitalisation expenses. The medication cost is covered during the time of hospitalisation, and up to a maximum of 5 days after that. Under the scheme, some State Governments are providing additional coverage of up to Rs.7,500 for a family per year for outpatient visits.
25th November 2016
First Ever Family Health Insurance Scheme to be Launched in Andhra Pradesh
Andhra Pradesh is soon going to become the very first state in India to launch a family health insurance scheme. The initiative, which was recently announced by the chief minister, N Chandrababu Naidu, will begin from January 1, 2017 and allow families to avail health care insurance at a nominal premium of Rs 100 per member.
Making the announcement for the launch of the program, Chief Minister N Chandrababu Naidu mentioned that Andhra Pradesh the very first Indian state to undertake such an initiative which will strive to provide the best global health insurance practices, but also notable international organizations such as the Bill Gates Foundation, World Health Organisation and several other similar organizations will be a part of the scheme. He promised that best will be introduced. The scheme is estimated to cost Rs 160.56 crore and allocations required for the scheme will be sanctioned in the coming budget.
24th November 2016
Mental Health Bill To Change The Face Of Health Insurance?
The Mental Health Bill, which was recently passed in the Rajya Sabha and is pending approval in the Lok Sabha, could change the face of health insurance for those with mental illnesses in the country.
An estimated 15 crore Indians do not have access to health insurance coverage for their mental illnesses. As of now, no insurance company, either private or state-run, covers mental illnesses.
A study by the National Institute for Mental Health and Neurosciences (NIMHANS) has revealed that a growing percentage of Indians have mental illnesses, which eats into their savings as they have to fund the cost of treatment themselves.
Mental illnesses like bipolar disorder, depression and severe forms of anxiety can impede daily functioning, making it difficult for afflicted individuals to pursue careers and cover the cost of treatment.
If the Bill is passed, it would compel insurance companies to cover mental illnesses under health insurance policies.
23rd November 2016
Increase in pollution necessitates health insurance
The Central Pollution Control Board (CPCB) has shortlisted 41 cities in the country where the level of pollutants in the air are very high. When air pollution is coupled with unhygienic water, there is bound to be an increase in health hazards. To protect yourself against water-borne ailments or cardiovascular diseases, it is important to be adequately covered by a health insurance policy.
CPCB stated that they have witnessed a 15-18% rise in claims related to ailments arising from water pollution. They have also observed a 12-15% increase in claims related to air pollution. Future Generali India Insurance has reported that claims related to respiratory disorders have increased from 4.3% to 7.5% in the past three years. ICICI Lombard also stated that the number of claims due to ailments arising from the consumption of polluted water has been on the rise. Royal Sundaram General insurance observed that claims for lifestyle diseases are lower in number when compared to claims submitted for communicable diseases.
It is advisable to be insured by a comprehensive health insurance cover to protect yourself from a number of ailments.
23rd November 2016
New Health Insurance Scheme to be Launched in Jharkhand in December
The Jharkhand government has announced that it will be launching a new health insurance scheme, called the ‘Mukhyamantri Health Insurance Scheme’ in the month of December. The scheme will cover residents of the state and provide Rs.2.50 lakh cover for general diseases. The scheme will additionally provide Rs.2.50 lakh coverage towards the cost of serious illnesses.
The scheme, which was originally part of the National Health Insurance Scheme for MNREGA and Below Poverty Line (BPL) individuals, will now be a standalone scheme. Individuals who are under the purview of the National Food Security Act will also be covered under this scheme, which will cover over 2,000 illnesses.
22nd November 2016
Odisha Journalists Receive Health Insurance Coverage to Mark Press Day
The National Journalist Welfare Board of Odisha has provided journalists in the state with health insurance and pensions as part of the National Press Day commemorations. The pension was provided to journalists above the age of 65 years, while the health insurance was provided to all journalists accredited with the body. The health insurance cover is Rs.25,000 per annum, while the pension provided will be Rs.500 per month. The board expressed the hope that this step will help journalists meet the cost of healthcare incurred while reporting.
22nd November 2016
Health insurance disputes top the list in Chennai
Insurance ombudsman, B N Mishra stated that the number of people involved in health insurance disputes with insurers are the highest in Chennai. He mentioned that Bhubaneswar witnesses a lot of insurance disputes over death claims, while in Chennai, the main issue is that people are not reporting pre-existing medical conditions while signing up for an insurance coverage.
Out of the 1,170 complaints that the Chennai Ombudsman office received in 2015-16, 67% were ruled in favour of the policyholders. It was also observed that the number of complaints received against private insurers were more than that for the public sector firms. The floods that rocked the city of Chennai also contributed to an increase in the disputes regarding home insurance claims recently.
21st November 2016
Ageing Indian Employees at a Higher Risk of Contracting Diabetes: Apollo Munich
The World Health Organisation estimated that India will have around 101 million diabetics come 2030. At the moment, there are around 70 million individuals who have the disease across the country, and an additional 80 million people fall in the pre-diabetes stage. In comparison with rural areas, urban India’s residents are 6 times more likely to contract the condition, and Apollo Munich Health Insurance, on World Diabetes Day 2016, revealed that people who are aware of the causes and cures for the condition continue to follow unhealthy lifestyles, and has urged people to take more care of their diet to ensure that they are not victimised by the disease at any stage in their lives.
18th November 2016
Rise in the Costs of Health Insurance for Respiratory Related Problems
It was recently reported that the level of air pollution in Delhi has gone up to an alarming level after Diwali. This has led to a rise in the costs of health insurance. According to a recent report, for a person suffering from respiratory and breathing problems, the health insurance cost will rise by 10-25%. One of the senior officials from Reliance General Insurance said that the claims related to respiratory issues will increase more as the pollution is rising every year. Increase in premium will also affect the senior population. The pollution has also affected the lung capacity and the immunity levels of the people residing in Delhi. All these would lead to people filing more health insurance claims.
16th November 2016
ICICI Lombard partners with 92.7 Big FM for a campaign
ICICI Lombard, which recently unveiled the ‘Do The Difficult’ campaign to inspire more people to live a healthy way of life, has partnered with 92.7 Big FM for marketing reasons. Through this campaign, ICICI Lombard is going to introduce a new health insurance policy which would let consumers get reimbursements on health benefit activity fees like zumba fees and gym membership fees. This show which ran for about a month involved the FM channel integrate their channel with a show titled ‘Do The Difficult’, wherein RJs highlighted different health issues and ways to stop them.
Topics related to diabetes, cholesterol, workplace stress and balancing lifestyles were the topics discussed on the show. Besides, the show also featured a different guest speaker that has turned his/her life by losing weight, quitting smoking, etc. Apart from listener engagement on-air, they were also encouraged to share their success stories with the hashtag #DoTheDifficult on Twitter.
9th November 2016
TPAs losing out on business as insurance companies settle claims in-house
Third Party Administrators (TPAs) are losing out on claim settlement requests as most of the insurance have decided to take care of claim requests themselves. In latest news, it is being said that as many as eight insurers including Bajaj Allianz, CIgna TTK, Star Health, and ICICI Lombard have started servicing claims through their in-house departments.
During 2015, a total of 92.36 lakh general insurance claims were filed which resulted in payments of Rs.18,223 crores in settlement. Out of these over 55% of the claims were settled through TPAs, while the remaining 45% were taken care of by the companies themselves. This number is starkly different when compared to 2005, where over 80% of settlement claims were handled by TPAs. However, with insurers initiating their own ‘claims department’, the number is expected to go down further more.
8th November 2016
GHMC proposes to offer health insurance to corporators amidst financial crisis
Recently, the Greater Hyderabad Municipal Corporation (GHMC) has been suffering from severe financial crisis to the extent that they have been unable to bear monthly salaries of their staff. In spite of this burden, they have decided to offer mobile phones and health insurance to all their corporators and co-option members.
Several standing committee members have been appointed to study the issue and submit a report to leverage these facilities. This would amount to an additional burden of crores of rupees on the GHMC, which is already in a cash-starved situation. The recent lack of funds has prompted the corporation to take up only maintenance work, putting all new projects on hold. It is interesting to note that corporators have been pressurising the corporation to provide them additional facilities like laptops with printers and the permission to go on funded study tours across the country. The previous GHMC council that extended such benefits to its corporators had satisfactory finances.
7th November 2016
Morgan Stanley raises target for ICICI Bank based on higher valuations for its insurance arm
Morgan Stanley ups the price target for ICICI Bank from Rs.255 to stand at Rs.266. This was based on the higher valuations of ICICI Prudential. The life insurance subsidiary of the bank is now valued at Rs.52,300 crore, contributing to Rs. 48 per share for the bank in SOTP valuation.
Morgan Stanley stated that the shares of the bank will be volatile, and to improve the stocks they should focus on existing non-performing loans and the bank’s operating profit margins. In the quarter that ended on June 2016, the non-performing assets of the bank rose to 3.35% from the previous value of 2.98%.
4th November 2016
66% Rise in Net Profit for Bajaj Allianz General Insurance
A recent report reveals that there has been a rise of 66% in net profit for Bajaj Allianz General Insurance. The current net profit is Rs.234 crore. According to Tapan Singhel (Managing Director), this rise can be attributed to various factors such as contribution from the direct business models, underwriting decisions etc. Also various investments done to improve distribution led to this growth. The crop insurance premium has increased from Rs.159 crore to Rs.737 crore this year. There also has been 20% rise in the retail health insurance portfolio. The same trend can also be observed in gross written premium which increased by 45%. The net income increased from Rs.288 crore to Rs.366 crore this year. The underwriting profit increased from Rs.20 crore to Rs.29 crore this year.
3rd November 2016
Launch of Arogya Abhiyana Campaign
In an effort to spread awareness among people regarding the various health schemes, the Department of Information and Public Relations (Government of Karnataka) has recently announced a campaign. The campaign is titled Arogya Abhiyana. As part of this initiative, various events such as street plays, singing events, etc. will be organized in many villages to promote the health schemes. The department will speak about different health schemes such as Vajpayee Aroyashree health scheme, Rajiv Arogya Bhagya Scheme etc. The department has plans to cover almost 186 villages spreading across Hunsur, K.R.Nagar, Mysore and Periyapatna Taluks.
2nd November 2016
India’s First Dental Insurance Plan Launched by OCare
OCare, an independent insurance Process as a Service (PAAS) platform, has launched the country’s first dental insurance plan. The product was launched on Diwali and the company hopes to make dental care affordable and accessible to all Indians through covering the cost of dental procedures. The plan is a group dental insurance plan with a Sum Assured of Rs.25,000 per person and will cover pre-existing dental conditions as well as all expenses arising out of dental procedures and services. The plan does not have a waiting period and will also provide dental check-ups twice a year as well as a loyalty card which can be redeemed through dental services.
With an aim to spreading awareness about dental insurance among Indians, the company plans on offering this product through Gram Panchayats across the country, making it accessible to rural India as well. The village of Vihigaon in Maharashtra has become the first Indian village to be covered under OCare’s dental insurance plan.
1st November 2016
SBI General Insurance continues to focus on motor and health insurance sectors
Addressing the audience at a press meet in Chennai, Andrew Farlow, Deputy CEO of SBI General Insurance, stated that the company will be focussing on auto, SME and health insurances to a large extent. He also mentioned that SBI General has always provided assistance to customers in the face of natural calamities. They had offered ample support to policyholders during the Chennai floods by processing 86% of claims and settling amounts close to Rs. 45 crore.
The company has seven branches in Tamil Nadu, and makes their insurance products available across 1000 branches of the State Bank group. 25 brokers and 728 agents are on the field to service their corporate and retail customers.
Their auto insurance business accounts for 51% of policies sold, and fire insurance contributes to 25%. The health insurance line accounts for 11% of their business. Their Arogya Premier, Arogya Plus and Arogya Top-up policies are noteworthy in their offerings to customers.
27th October 2016
Chhattisgarh Government Adopts the Niramaya Health Insurance Scheme
A recent report reveals that the Chhattisgarh government has decided to adopt ‘Niramaya’. It is a health insurance scheme exclusively meant for people suffering from Autism, Cerebral Palsy, Mental Retardation and Multiple Disability. The maximum amount covered by this plan is 1 lakh. The premiums will be paid by the state itself. This scheme would provide different kinds of services to people ranging from medical check-up, therapy, surgeries etc. According to Sonmoni Bora (Secretary, Social Welfare Department), this scheme would definitely help reducing the financial burden of the people belonging to below poverty line. The applicants are required to submit a valid disability certificate. After the application forms are approved, a health card along with an e-card would be issued to them. A nominal processing fee will also be charged.
26th October 2016
Meghalaya Govt. to Continue with Megha Health Insurance Scheme
The Meghalaya government has stated it will not be abandoning the Megha Health Insurance Scheme II (MHIS II), which is set to lapse on October 31st, 2016. According to the Health Department, the government is actively looking for a new insurer to ensure the scheme continues. The policy tenure for MHIS II was August 1st, 2015 to July 31st, 2016 but the scheme was extended up till October 31st, 2016. The government has stated it will not be discontinuing the plan as it is very beneficial to citizens, with over 3,46,548 beneficiaries currently enrolled in the scheme.
The scheme covers over 210 hospitals, which includes 15 private hospitals and 109 primary health centres within the state as well as 44 private hospitals outside the state. The second phase also included the provisions of the Rashtriya Swasthya Bima Yojana, which provides health insurance cover of up to Rs.30,000 to families below the poverty line, in addition to the Rs.2 lakh cover provided under the MHIS II scheme.
25th October 2016
Most of the Indians Underinsured When it comes to Health Insurance
Indians are gradually buying health insurance but are underinsured, according to various industry insiders. A study by Apollo Munich has revealed that close to 51% of Indian health insurance policyholders have low Sum Assured insurance policies which would not cover the cost of medical treatments. Underinsurance only leads to higher medical costs and a more stressful time for the policyholder during medical emergencies, in addition to creating a false sense of security.
Analysts estimate around 20% of the population has some form of health insurance but most of these insured individuals have inadequate cover. While the government health insurance schemes such as the ESIC provides adequate coverage, this is only a fraction of the population who have coverage. This is due to individuals choosing policies with the bare minimum coverage in an effort to lower premiums. Most individuals prefer putting money into a life insurance premium, leading to health insurance policies being low priority.
24th October 2016
Religare Makes Improvements in its Flagship Product CARE
Redesigning the existing product line, Religare Health Insurance has announced a new edition of its health insurance policy CARE that will cater to a wide range of healthcare needs. According to the company, the number of critical illness benefits have been increased from 5 to 12 under the “Care Anywhere” plan. The company aims to enhance value and convenience by offering an additional insured sum of 75 lakh rupees plus a maternity cover of 1 lakh. Moreover, the list of day care medical procedures too have been raised from 175 to 541. Religare also provides cover for Ayurveda, Unani and Homeopathic treatments.
21st October 2016
Insurance companies worried over group health discounts
To please customers, insurance providers in the health segment have been doling out discounts for corporate customers. However, this development is becoming a major concern for non-life insurance providers who are worried that the move might jeopardise the insurance industry. The discounts haven’t looked like stopping even after IRDAI’s directive that companies offering health insurance policies need to maintain a high level of solvency.
Speaking about this issue, an executive from a mid-sized insurance company said that private companies are limiting their exposure by offering discounts to their customers. He ruled that these companies are using such tactics so as to retain high-worth corporate customers. He also said that non-life insurance companies are likely to stake a claim and ask the regulator, IRDAI, to revise the solvency ratio problem that are affecting other insurance players.
21st October 2016
Workers Will Be Able to Opt For Health Insurance Plans Other Than ESI
The Labour Ministry will be introducing a Bill allowing workers to choose health insurance plans other than the mandatory health cover provided by the Employees State Insurance Corporation (ESIC). Formal workers earning under Rs.21,000 a month are currently compulsorily covered under the ESIC-run health insurance scheme at present. The Bill is part of the EPF and MP Amendment Bill, 2016 and will seek to amend the ESIC Act of 1948, allowing beneficiaries of the ESIC to choose any health insurance plan they desire.
This move has been opposed by labour unions, who have raised concerns about possible exploitation of workers by private health insurance companies. They also contend that there are few policies that match the benefits that are provided under the ESIC health plan. The unions had written to the government to express these reservations and requested the government to develop a mechanism that ensures benefits under the ESIC scheme and other health plans are on par.
20th October 2016
Complete Health Cover Launched by Oxxy
Oxxy has launched a new health insurance policy that the company calls a ‘complete solution’ for a family. The plan provides a range of covers, such as a lifetime health plan for each new-born child along with life insurance cover up to Rs.1 lakh for the mother. The plan also makes provision for a fixed deposit of Rs.11,000 for every girl child in the family.
It aims to ensure complete health protection for all members in the family with a special emphasis on the girl child especially given the lack of adequate health care options in the country. The plan caters to the needs of all members without the added cost of coverage. The company plans to focus on prenatal welfare and healthcare as well, with this plan being the first step towards this. The company also plans to register expectant mothers to the Child Development Programme, which will provide essential health care and services for free.
19th October 2016
8000 Crores to be Set Aside for Prime Minister’s National Health Insurance Scheme
Prime Minister’s National Health Insurance Scheme, an ambitious project of the government, is expected to bring off revenues worth Rs. 8000 crores to insurance companies. It aims to provide insurance covers of up to Rs. 1 lakh for poor families in the country. The current national health insurance programme, Rashtriya Swasthya Bima Yojna (RSBY) will be scrapped if the new health insurance scheme comes into effect. Under RSBY, more than 11 million hospitalizations were attended throughout the country. According to a health ministry official, around Rs. 5000 crores should essentially be allocated for the new scheme to firm up. The split of financial contributions by Centre and States for this project will be 60% and 40% respectively.
18th October 2016
US Healthcare Major Aetna Announces Rs. 100 Crore Investment in India over Next 3 Years
Aetna, the 160-year-old healthcare benefit company headquartered in the US recently announced its commitment to invest Rs. 100 crore in the Indian market over the period of the coming 3 years. With the help of its fully-owned Indian arm, Indian Health Organisation, Aetna has launched a new product called ‘Classic Family Consultation Membership’ which has been designed specially to allow customers to meet their daily outpatient expenses.
The membership is priced at Rs. 5,880 for a period of 1 year for a family of 4 members. As a part of the membership, the members can avail unlimited tele-consultation with doctors along with getting 10 doctor consultation vouchers, free of cost, which can be used at some leading hospitals and clinics. The membership also enables holders for tax exemption under Section 80D of the Income Tax Act, along with attractive discounts of up to 50% on diagnosis, medicines, diagnosis, consultation and further treatment.
17th October 2016
General Insurance Industry Struggling To Implement KYC Norms
Insurance providers in India have been directed to upload data onto iTrex, a digital platform designed for insurers and insurance repositories which will help them search for e-insurance account details and exchange policy and e-KYC data. While few problems are being faced by life insurance companies in implementing uniform KYC (know your customer) norms under iTrex, the general insurance sector, on the other hand, is struggling to implement those norms. The industry has requested an extension on the Oct 1 deadline to carry out implementations.
17th October 2016
September Sees General Insurance Premiums Grow by 88%
The direct premium growth posted by general insurance companies rose by 88% in September 2016(year-on-year). The increase in premium growth is likely a result of crop insurance according to industry sources. The jump in premium income is quite significant, with insurers receiving Rs.15,087.01 crore as opposed to Rs.8,029.59 crore in the same period the previous year. When split into private and public sector performance, the public sector registered a growth of 51% in premium revenue compared to the previous year while the private sector recorded an increase of 66.9%.
There was a higher involvement from private players compared to public sector insurance companies over the past few months which saw sustained growth. The standalone health insurance sector posted growth of 48.2% in income from premiums in September. This has given a major boost to non-life insurance, which found it difficult to cross the Rs.1 lakh crore benchmark last year. So far, non- life insurance has already crossed Rs.60,000 crore as per September 2016 data.
13th October 2016
National Insurance Reveals that Soft Reinsurance Rates are a Problem
As experienced over the past six to seven years, global reinsurance rates continue to remain soft, according to Sanath Kumar, the Co CMD of National Insurance. He added that the company was expecting a turnaround in 2016, but market condition ensured that they remained mere expectations. Mr Kumar also said that a few of the insurance portfolios such as health and motor have heightened competition at the moment, and have loss ratios ranging between 150% and 160%. As a result, the general insurance companies that are being incorporated nowadays are counting on future investment income.
12th October 2016
IRA Seeks Centre’s Support to Get Medical Insurance Benefits
The Indian Rheumatology Association (IRA) is seeking the Centre’s support to get insurance coverage for inflammatory arthritis patients, who are currently not covered under medical insurance.
The IRA, on the occasion of World Arthritis Day, has forwarded a petition to the Union ministry of Health and Family Welfare and IRDA (Insurance Regulatory & Development Authority), in which it has requested to include inflammatory arthritis under the category of diseases which are covered by insurers, private and public. Though the condition itself does not pose a threat to one’s life, but it does result in the patient losing the ability to carry out routine activities.
12th October 2016
Exide Life Insurance Introduces ‘Sanjeevani’ to Provide Cover for Cancer & Heart Conditions
Exide Life Insurance, one of India’s leading insurers, recently announced the launch of 'Exide Life Sanjeevani', an all-round health cover for cancer and heart related conditions. As a part of this plan, if the insured is diagnosed with any early or major stages of a cancer or heart related condition, then they will be provided with a fixed lump sum benefit, along with a waiver on of future premiums. The plan will also allow the diagnosed insured individual to make a claim even if they are already covered under an existing health insurance policy.
The benefit lump sum amount will be paid under three categories which are Mild (25% of chosen sum assured will be provided), Moderate (505 chosen sum assured provided) and Severe (100% of chosen sum assured paid). However, if the insured is diagnosed with more than one condition simultaneously, then the complete benefit amount will be paid.
10th October 2016
HC Seeks Response from IRDAI over Unpaid Hospital Bills
The Bombay high court has sought a response from the IRDAI on initiating a scheme whereby hospitals can recover unpaid dues. The matter came up as a result of a PIL filed regarding a practice where the hospital refuses to release a patient or corpse until all dues are cleared.
A bench of the court asked if patients without health insurance could be insured by the hospital with assurance from insurers to pass such a claim.
A representative of IRDAI had raised the possibility of a scheme where the hospital would receive the unpaid bill amount from insurance companies. IRDAI has also contacted a few of the public sector insurance companies to explore the feasibility of such a scheme. The court also remarked on how publicly funded health insurance, similar to the schemes in countries like the NHS in England, could be implemented here so as to benefit all sections of society.
7th October 2016
Health Insurance Scheme Launch Postponed to Oct 21st
The launch of the Maharashtra government’s flagship health scheme, christened the Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) has been postponed. The scheme was scheduled to be launched in August but delays have resulted in the launch being postponed to October 12th, 2016.
The scheme was earlier known as the Rajiv Gandhi Jeevandayee Arogya Yojana (RGJAY) but was revamped and rechristened. In its new avatar, the scheme will cover over 1,100 ailments instead of the earlier 900. According to government officials, the delay in the scheme’s launch is due to administrative issues and the lack of adequate response to tenders floated for it.
7th October 2016
Pay-As-You-Workout Concept to Build a Health Conscious Lifestyle
Going in line with the premium offerings of General Insurance, some of the Health Insurance companies too have come up with exciting products. The pay-as-you-workout concept of Cigna TTK comes under the “Get ProActiv India” program which was announced by the company on World Heart Day. This package allows customers to redeem their reward points and use it for reduced bill payments and doctor consultations.
According to Sandeep Patel, CEO of Cigna TTK, the company has launched a mobile app which can be integrated with fitness wearables such as Garmin Vivoactive or FITBIT Surge Fitness Tracker. The application maintains fitness logs based on which reward points are generated. Policyholders can make use of these points towards the end of the year against health insurance services.
30th September 2016
Poor Response to Deen Dayal Swasthya Seva Yojana in Salcete
Despite having been received well in the constituencies of St. Cruz, Panaji and Taleigao, the Deen Dayal Swasthya Seva Yojana (DDSSY) has not managed to evoke as warm a response among the residents of Salcete. The DDSSY health insurance scheme was recently launched with the aim of providing the benefits of health insurance to every single citizen in Goa, irrespective of their caste, income or religion. Goa Electronics Limited (GEL) recently announced that it will be issuing DDSSY cards to patients in a very short time, provided the patients have approached with a genuine emergency and possess all the required documents.
28th September 2016
Apollo Munich Survey: 51% of People with Health Insurance Policies are Under Insured
Nearly 51% of Indian individuals who hold health insurance policies are under insured, even though a gradual rise in policy sales has been recorded in recent times. Apollo Munich Health Insurance released a report according to which most people with under insured policies purchased policies with relatively low sum insured which did not prove adequate in medical emergencies. The report said that despite the fact that there is a yearly increase in the number of health insurance policyholders in the country, people often select policies with the lowest sum insured without understanding the whole process of selecting the right cover.
Around 7 lac health insurance policyholders were covered under the study across 82 Indian cities, and it was found that men and women were under insured across Tier I and Tier II cities as well as metros.
28th September 2016
PM National Health Insurance Scheme Expected to be a “Gamechanger”
Faggan Singh Kulaste, the Union Minister on Thursday said that the PM National Health Insurance Scheme that remains under consideration as of now, will be a “gamechanger”. He also pitched for discussion between stakeholders, including insurance and health industry for successfully implementing the plan. He also revealed that the national health insurance scheme has expanded the current scheme for BPL individuals under the RSBY (Rashtriya Swasthya Bima Yojana with over 75% coverage. So far as benefits and coverage is concerned, the Union Minister revealed that the Prime Minister’s insurance scheme will change the face of the game.
27th September 2016
Andhra Bank Ties Up With Cigna TTK and Reliance General
Andhra Bank has signed an agreement with Cigna TTK, a private health insurance company, according to a statement released by the bank. As per this agreement, Cigna TTK will be providing health insurance products to Andhra Bank account holders, according to the bank’s Executive Director.
The bank has also tied up with Reliance General Insurance, who would be providing general insurance products to account holders. The two deals will benefit both the bank as well as the insurers, as the insurers will be able to tap a large potential market and customers will have a choice when it comes to selecting insurance products.
27th September 2016
General Insurance Companies Register 19% Growth in Direct Premium this August
The month of August turned out to be profitable for general insurance companies who registered positive growth of 19.1% in total direct premium. Data published by the General Insurance Council indicates that private insurers have gained more in terms of premium underwritten, compared to their public sector counterparts. However, specialized insurers like AIC and did not register positive growth.
The general insurance sector witnessed a rise in their overall premium income, which went up to Rs 9,013.97 crore in Aug 2016 from Rs 7,566.81 crore recorded in August 2015. Private players were at the forefront and recorded an overall rise of 40.1% in their premium income which stood at Rs 4,126.26 crore this year, as compared to the previous year. The public sector, on the other hand, recorded a growth of 15.2%, which stood at Rs 3,825.19 crore in August, 2016.
26th September 2016
Assam Govt. Launches Atal Amrit Abhiyan Health Scheme
The Assam Government, led by BJP, recently announced the initiation of the Atal Amrit Abhiyan, a health insurance scheme that will provide coverage against 5 life-threatening diseases. To be launched on April 1, 2017, the scheme will be operational on an individual basis.
Speaking on the occasion of the announcement, Himanta Biswa Sarma, Health Minister for the state of Assam mentioned that under the Atal Amrit Abhiyan, beneficiaries will be able benefit by availing cost-free treatment for 5 critical ailments such as neuro surgery, heart surgery, burns, kidney failure and cancer for up to an amount of Rs 2 lakh at hospitals across the country.
21st September 2016
Cab Drivers to Receive Health Insurance through Tata AIG-Paytm Venture
Cab and auto drivers are all set to receive health insurance through a new venture by Tata AIG and Paytm. Under this scheme, drivers who use Paytm’s digital wallet can avail cashless health insurance provided by Tata AIG. The schemes are tailor-made for drivers, giving them access to quality medical care up to Rs.50,000. Existing health conditions will also be taken into account when the drivers opt for this scheme. The scheme is set to be launched in Mumbai soon after receiving a good response in Delhi. Based on response, the scheme is to be rolled out across the country.
20th September 2016
Star Health Expecting Gross Written Premium worth Rs. 2,800 Crore in 2016-17
India’s biggest stand-alone health insurance company, Star Health, is expecting Rs.2,800 crore worth of gross written premium by the end of the 2016-17 financial year, as revealed by one of the top representatives of the company. The company, which is based out of Chennai, recorded a sales revenue of Rs.2,007 crore in 2015-16, and hopes to continue targeting retail customers instead of group policies. The official also revealed that the company is expecting to cover around 90 lakh people in 2016-17. Star Health, which currently boasts almost 50% market share, is promoted by private equity companies such as Tata Capital, APIS, Sequoia Capital and ICICI Venture.
19th September 2016
IRDAI Direction Causes Slump in Life Insurers’ Health Portfolio
The general health business is forecast to experience a decline for life insurers following the insurance regulators decision to ask life insurers to withdraw indemnity-based health products. IRDAI (Insurance Regulatory and Development Authority of India) revealed that life insurance companies cannot provide indemnity-based products to groups or individuals. However, a noted official of a mid-size life insurance provider revealed that the industry might withdraw these plans, but individuals who already hold such policies can retain them until their expiry regardless of how long the policy term might be. IRDAI also added that companies will also have to refrain from offering single-premium health insurance products under the unit-linked platform.
19th September 2016
Rising Health Costs Responsible for Increase in Health Insurance Buys
A survey undertaken by ICICI Lombard General Insurance revealed that most people purchase health cover in order to offset the rising costs of medical treatment. According to the survey, 58% of respondents had a health insurance plan, and over 23% of respondents agreed that lifestyle had a large impact on their overall health.
A whopping 85% of respondents stated that the reason behind their opting for a health insurance plan was to cover the costs of medical treatment, with 82% stating the availability of good treatment through health insurance as an additional reason for paying for health coverage. 72% of the respondents stated the reason behind their opting for health insurance was to avail tax benefits, indicating this is fast emerging as a reason behind getting health coverage.
16th September 2016
Insurance Marketing Firms New Kids on the Insurance Block
Up till recently, insurance products were being sold through insurance brokers, agents, direct sales and microfinance institutions. From 2016, Insurance Marketing Firms (IMFs) made an entrance, being the latest channel to sell insurance. The reach of insurance in India is still quite small, with insurance products being bought by a small percentage of the population.
With the launch of IMFs, it is hoped that the insurance distribution at district levels will increase due to greater penetration by encouraging entrepreneurs to set up their own IMFs selling general, life and health insurance products. IMFs will also offer agents to scale up their operations and sell a diverse range of products under the IMF umbrella. Insurers will also benefit as they will have a greater pool of agents selling their products instead of just one agent through the old arrangement.
15th September 2016
Listing of General Insurance Firms Gains Momentum
The government’s move to list PSU general insurance companies is going full steam ahead, with the government seeking information on business members and financial projections ahead of the listing. The Finance Minister had announced that PSU general insurance companies would be listed on the stock exchanges during his 2016 Budget speech.
Accordingly, New India Assurance, General Insurance Corporation of India, Oriental Insurance, National Insurance and United India Insurance will be listed on the bourses. The information sought by the government on the performance and projections by the companies is likely to be completed by the end of the financial year, though a date for the listing has not yet been set. While the insurers have performed well, underwriting losses, particularly in the health and auto sector, remain a cause for concern, and cutting these losses is the main objective before the listing.
14th September 2016
Lifeline Health Cover Launched By Royal Sundaram in UP
The Royal Sundaram General Insurance Company has launched ‘Lifeline’ in Uttar Pradesh. Lifeline is a flagship health insurance product that is serviced by doctors and offers the largest array of services form Rs.2 lakh up to Rs.1.5 crore. The scheme has 3 sub-plans that offer a wide range of services depending on the needs of the policyholder. Divided into Classic, Supreme and Elite, the plans cover individuals from 3 months to adults.
Some of the features offered under the scheme include 100% reload benefit along with no claim bonus, Ayush treatments and health benefits, among others. The policy also covers the cost of taking a second opinion for up to 11 critical illnesses.
8th September 2016
50 Lakh Workers to Receive Health Insurance after ESIC Raises Pay Ceiling
The Employee State Insurance Corporation (ESIC) has raised the wage ceiling to Rs.21,000 per month in an effort to include more workers under its health insurance scheme. The wage ceiling will be raised from the current Rs.15,000 to Rs.21,000 per month, resulting in over 50 lakh workers being eligible for benefits under the ESIC’s various schemes.
This follows the government’s recent minimum wage hike for unskilled non-farm workers to Rs.350 per day from the previous Rs.246 per day. Consequently, ESIC raised its wage ceiling by 40% to keep in line with the government’s move. ESIC will also be allowing workers whose salaries breach the wage ceiling to continue to receive benefits from its schemes effective October 1st 2016.
8th September 2016
Apollo Munich Wins Best Health Insurance at FICCI Awards
Apollo Munich Health Insurance won the ‘Best Health Insurance Plan’ award for its Dengue Care plan at the FICCI Awards 2016. The unique plan has received accolades for its comprehensive coverage that protects policyholders in the event of a dengue diagnosis. The ease of accessibility through the user-friendly three-click process and simple pre-filled forms also resulted in the company bagging the award.
This plan, available to all, provides standalone indemnity for policyholders who contract dengue, the most viral disease in India at present. The plan covers hospitalization as well as home care and comes at an affordable Rs.444/- one-time premium. The plan provides coverage up to Rs.50,000 for in-patient expenses and up to Rs.10,000 for home care or outpatient treatment.
7th September 2016
Govt. Plans Unique ID to Track Health Insurance
The government is considering introducing a unique identification along the lines of the Aadhaar card to track National Health Protection Scheme (NHPS) beneficiaries. The NHPS is the flagship programme under the government’s health insurance plans and it aims to provide health cover up to Rs.1 lakh for Below Poverty Line (BPL) individuals. It is scheduled to be rolled out by April 1st, 2017.
The idea for the unique ID came about as all citizens do not yet have Aadhaar cards and it is difficult for the government to track beneficiaries without adequate documentation. This will also ensure all citizens receive health insurance and the ID will reduce the possibility of duplication of documents. The NHPS will cover over 8 crore BPL families in its initial stage and will cover around 40 crore people over time. Over 1,600 procedures will be covered under the plan, which can be conducted at any hospital.
6th September 2016
Private Equity Funds Acquire Stake in Star Health Insurance
Two private equity funds have acquired a minority stake in Star health Insurance for a sum of Rs.320 crore. Apis Growth Fund and India Advantage Fund Series 4 have both pumped in a total of Rs.320 crore, with Apis Partners paying Rs.220 crore and ICICI Venture’s India Advantage providing the balance Rs.100 crore.
The acquisition has resulted in Star Heath’s valuation moving above Rs.2,000 crore. The company is a market leader among pure-play health insurance in India, registering growth of over 36% in the previous financial year. The company is known for its innovative products and is an attractive investment opportunity, reporting a premium income of Rs.2,008 crore. The recent acquisition takes the number of private equity funds on Star Health’s board to 3, with Apis joining Sequioa Capital and Tata Capital.
5th September 2016
Group Health Insurance will be provided selectively by ICICI Lombard
ICICI Lombard, India’s biggest non-life insurer in the private sector has stated that group health insurance will be offered by them selectively, henceforth. Group Health Insurance schemes provide coverage for healthcare requirements to a certain group of people. Although ICICI did not come up with a particular number, they stated that the number of claims in the segment of group health and substantially gone up in the recent times.
More claims have been received under Group Health than Individual Health segment. Thus, the company has decided to choose who to work with and who not to work with, from now on. This information was provided by Sanjeev Mantri, the executive director of ICICI Lombard. However, he did not mention anything about the plea being client-specific.
1st September 2016
New Brand Campaign Launched by ICICI Lombard
A new brand campaign has been launched by ICICI Lombard that will run across all media platforms in India. This campaign is designed to highlight ‘Nibhaye Vaade’, the brand’s core proposition and at the same time it creatively communicates the company’s approach towards its customers. The new commercial is accompanied by digital and outdoor creatives and radio spots to ensure maximum consumer engagement. The digital campaign uses the hashtag ‘#DoTheDifficult’ to encourage customers to share stories of the obstacles they have overcame to fulfil promises that they had made to their loved ones.
Through its health and wellness solutions, ICICI Lombard aims to help its customers fulfil their personal commitments. Customers can enjoy various wellness benefits along with ICICI Lombard Health Insurance scheme, which includes gym and yoga reimbursements, fitness and sports therapy, nutrition consultation, etc.
31st August 2016
Survey says only 10% households in Assam have Health Insurance
As per the recent NFHS-4 (National Family Health Survey), only 10.4% families in Assam have a family member who has a health insurance scheme. IIPS (International Institute of Population Sciences) was made the nodal agency by the Ministry of Health and Family Welfare to carry out this survey. The information was collected from 24,242 families and field work for the survey was done by Nielsen (India) Pvt. Ltd. Compared to Assam, Meghalaya, Arunachal Pradesh, Sikkim and Tripura had higher percentages. The same survey showed that Tripura had 58.1%, Sikkim had 30.3% and Meghalaya had 34.65% families that had health insurance. The Universal Health Insurance Scheme introduced by the CM of Arunachal Pradesh ensured that the state had the highest number of insured families. Lack of awareness and communication gap has been cited as major reasons for the low percentage in Assam.
30th August 2016
Max Bupa Ties Up With Sarva U.P Gramin Bank to Offer Health Insurance Policies
Country’s leading general insurance player from the private sector Max Bupa has partnered with Uttar Pradesh based SUPGB (Sarva U.P. Gramin Bank) to offer comprehensive health insurance products to the customers of the latter. Under this bancassurance deal, Max Bupa customized health plans to over 35 lakh customers of SUPGB in about 17 districts at low premiums.
While one health insurance policy with a cover of Rs.50,000 will be offered for an annual premium of Rs.1,557, the second plan will come at a premium of Rs.2,008 for a Rs.1 lakh cover. These family oriented health insurance policies will work just like any other health policy and covers pre and post hospitalization expenses. It also covers maternity benefits, child immunization costs and along with other comprehensive features to ensure all-round health cover.
29th August 2016
IRDA Bats for Lesser Third Party Interference, Drafts New Rules to Contain Influence
Taking cognizance of grievances raised by consumers, IRDA has issued a new draft aimed at creating a compliance framework with regard to outsourcing activities in the insurance sector such as underwriting, product design and others. Aimed at improving standards and tightening the processes involved, the market regulator has issued a new draft to ensure standard practices during delivery.
IRDA has also said that core activities involved in issuing insurance policies such as underwriting, risk management and others should be handled internally and not be outsourced. One of the most common concerns pertains to online premium payment and issuance of policy on the channel. Due to net banking and payment gateway issues, there are delays/declines in premium payment. This draft proposal also states that such payments should be instantaneous and the receipt should be available on the spot.
The draft also talks about putting a blanket ban on outsourcing grievance handling mechanism to a third party. Another important point provided in the draft deals with sub-brokers and agents having license for regular operations such as document collection from customers.
26th August 2016
Apollo Munich introduces their online game
Mumbai: Taking a swat at mosquitoes and monsoon bugs can be bugging unless the bat connects. Apollo Munich has turned this commonplace evening activity in the city into a fun interactive game. It is called ‘Kill the Killer’. Apt, right? Informative, educative and entertaining. You can play this game on the company’s official website. You are given 20 seconds to swat at mosquitoes. The more you kill, the more you score. The scores can be shared on your social media pages. You may also invite your friends for a good old competition.
22nd August 2016
Punjab Govt. extends free health cover for farmers by one year
Chandigarh: So as to offer free and improved healthcare services to the agriculturalists in the state, the government has protracted the free insurance cover (Bhagat Puran Singh Health Insurance Scheme, a joint initiative by the Punjab Mandi Board and the state government) by one year. A top official confirmed that this scheme under which over four lacs farmers have registered themselves aims to make to more beneficial and reachable. The expected outlays for this is INR 10.82 Cr.
22nd August 2016
Getting a Health Insurance from Apollo Munich is Now Quicker
Apollo Munich, India’s leading general insurance player from the private sector has cut down the policy issue time from 7-14 days to about 7 minutes. This joint venture company is cashing on technology to cut down the processing time and to simplify the sales procedure.
The company expects a considerable rise in business turnaround by about 65-70%. It is relying on an app known as Ampower. This app can be installed on the devices provided to the sales representatives where online forms can be easily filled with the help of information provided by the customers. Post the initial formalities, all related documents such as identity proof can be easily scanned and attached to the application form, saving oodles of time for the customer. At present, a little over 3,500 agents/representatives are using this app to pitch and make insurance sales on behalf of the company.
18th August 2016
IRDA Chief Bats for Widened Coverage to Boost Insurance Sales
The chief of IRDA (Insurance Regulatory and Development Authority), T.S Vijayan has urged the insurance sector in India to come up with innovative products which provide widened coverage to customers.
Speaking at the 18th Insurance Summit organized by the CII, he expressed his concern over the gap in people availing insurance versus products available in specific segments. He also stressed on wider channels for sales, higher claims settlement ratio and other factors for the industry to achieve double digit growth over the next 5 years. He also mentioned the need for better incentives to distributors to help them to penetrate better into the market to achieve the targets.
18th August 2016
Long-term & combo schemes for health insurance buyers
One reason why people hesitate to spend money on health insurance is that most schemes are designed for shorter terms. People consider renewing or buying new ones a hassle. Now you have the option of health covers for up to five years and for the initial three years, the premium will be same. There are also attractive combo offers. For instance, if you hold a life insurance policy, you may go for a ‘health plus life combo’. This new twist is sure to offer immense scope to the less-explored yet much-needed arena.
17th August 2016
IRDAI approval for Aditya Birla health insurance
Aditya Birla Financial Services Group (ABFSG) has announced that their health insurance sector finally snagged the regulatory sanction from country’s insurance ombudsman, IRDAI. They are excited at the prospect of commencing their operations in the health insurance arena in the final quarter of this fiscal. Mr. Mayank Bathwal, who has served the company for more than 20 years, was chosen as the CEO of their health insurance arm. Aditya Birla Health Insurance Limited is a combined undertaking between the Aditya Birla Group and MMI Financial Holdings Group based in South Africa. Health insurance in India is highly in demand yet not explored to its full potential. They are positive that their diverse insurance schemes and solutions will reach a wider audience.
17th August 2016
Uttarakhand Government promoting MSBY
Insurance in India is a matter of concern, with only a small portion of the population benefitting from it. Governments, both at the Centre and States have promulgated a number of schemes to increase insurance penetration, aiming to bring a larger portion of the population under its ambit. One such scheme which has been introduced by the Uttarakhand government is the Mukhyamantri Swasthya Bima Yojana or MSBY. A universal health insurance scheme, it was launched last year with the aim of providing health insurance cover to individuals across both segments of the poverty line. Individuals who are not eligible to pay income tax and who are not employed by the government are eligible for protection under this scheme. The first phase provided a cover of Rs. 50,000 under the scheme, which was increased to Rs. 1.75 lakh in the second phase.
The second phase of this scheme began from August 1, 2016 and the government is keen on getting more people under it. Local authorities are using multiple modes to spread awareness about this program, utilising traditional media like pamphlets, newspaper ads and hoardings to inform eligible members. Members of the public can get health cards from local government health centres or Asha workers. A total of 8.17 lakh cards have been given out to eligible members of the public, with around 35,000 claims made. The government has paid a sum worth Rs. 18.16 crore under the scheme towards the claims.
16th August 2016
GST to increase insurance costs by 300 bps
Your indemnification – vehicle, health and life will start costing more from next year (Apr 2017) as you will have to shell out to 300 bps extra in taxes. This is sure to weigh more on the pockets of the Indian middle class if they carry on relying more on insurance schemes to secure their future financially rather than investing in share markets. Certainly, schemes purely for protection will cost way more than the unit-linked indemnity schemes. Did you know that the government imposes service tax on the protection part and not on the savings part? Costs of term insurance products will shoot up 300 bps and add the 15 percent tax on it, which will be 18 percent.
9th August 2016
Government plans to increase number of health insurance schemes
Insurance penetration in India stands abysmally low, with just a minor percentage of our population covered by it. Given the growth and development that the country has witnessed in the recent past, the government is keen to increase these numbers, offering universal health protection to citizens. Estimates suggest that over 80% of the Indian population is not protected via insurance, with these numbers increasing in rural sections. A primary reason for this lack of insurance is the cost of purchasing and maintaining it, which is beyond the reach of most Indians. Existing schemes like the Pradhan Mantri Jeevan Jyoti Bima Yojana and Pradhan Mantri Suraksha Bima Yojana have found multiple takers but the numbers still don’t cover a huge chunk of the population.
The government, on its part, is keen to introduce new schemes to reduce the burden of payment on the general public. These schemes will soon be available, helping people meet their health insurance requirements. In addition to this, companies who have violated health insurance rules are also under the scanner, with 13 companies being looked at by the government.
5th August 2016
Apollo Munich to spend INR 50 crore to expand business
Though Apollo Munich is sufficiently financed currently, the firm will soon need more capital (around INR 50 Cr) by the end of this financial year, declared their CEO to the media. At present, its paid-up investment stands at INR 357 cr. Company could boost the growth by 27 percent in the previous financial year and in 2016-2017, they are anticipating a surge of at least 30 percent. They are banking on a newly developed app, Ampower for this new business expansion, which has already facilitated their sales team to deliver policies such as home insurance, health insurance etc. in seven minutes compared to the erstwhile standard period of a fortnight.
5th August 2016
CM’s health insurance offers respite to over 76,000 in Vellore
People belonging to economically backward groups (households with a yearly income of INR 72,000 or less) can claim this cover at all listed hospitals. This policy is called as the Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS) and has been in operation since five years. Ever since its commencement in 2012, the government has delivered over 8 lacs CMCHIS health cards in Vellore, benefitting some 76,509 people as per the recent data. Under this scheme, 6941 heart operations, cancer treatment for 14,855 people, and 12,317 dialysis has been performed. Eligible people shall collect the ID card from the collector’s office. Almost 92 percent members have registered themselves.
5th August 2016
Chattisgarh to Hike Chief Minister Health Insurance Limit to Rs.50,000
The Chief Minister of the Chhattisgarh, Dr. Raman Singh has announced a hike of Rs.20,000 in the Chief Minister Health Insurance Scheme. At present, the upper limit is fixed at Rs.30,000 under which eligible families can seek treatment in government and private hospitals.
Speaking at the award function Icon of Health Care, Dr. Singh made this announcement. He felicitated 39 doctors during the ceremony and lauded the service of doctors for their contribution to the improvement of health services in the state.
4th August 2016
Mukhyamantri Swasthya Bima Yojana (MSBY) Launched in Uttarakhand
A new health insurance scheme christened Mukhyamantri Swasthya Bima Yojana (MSBY) was launched in Uttarakhand on August 1, 2016. Families residing in the state would get an annual health cover of Rs.50,000 along with a critical illness cover of Rs.1,25,000 on a family floater basis.
This scheme does not include nuclear families, pensioners, income tax payers & select categories of government servants. The implementation of this scheme will be done by Bajaj Allianz General Insurance Company. This public health insurance scheme will also be available to members covered under RSBY (Rashtriya Swasthya Bima Yojna). The scheme is being rolled out to citizens through enrollment camps across the state scheduled from August 1 to 15th. The insurance would cover hospitalization expenses along with pre-post benefits for insured members.
4th August 2016
Puducherry government to launch health insurance scheme for pensioners
In a bid to offset the health problems faced by pensioners, the Puducherry government is all set to implement a health insurance plan exclusively for them. Titled the ‘Pensioners Health Insurance Scheme’, it would be implemented by the Directorate of Health and Family Welfare Services. The government is currently in talks with companies to offer this scheme to pensioners. Open to retired government staff members, it would cover various health issues faced by them post retirement. The primary issue faced with retired staff was that they couldn’t be a part of existing schemes, which are typically for people from below the poverty line, or those which had unique eligibility criteria.
Premiums towards these health insurance policies would be adjusted against the pension of an individual, ensuring that there is no additional financial burden on them. In addition to the pension scheme, the government will issue smart cards to patients who undergo treatment at hospitals, ensuring that they have complete information of the treatment, simplifying future health check-ups. The Union Territory has been free from polio since 1999 and has the lowest infant mortality rates for UTs, despite the fact that it has limited staff to man its hospitals.
2nd August 2016
Deen Dayal Swasthya Seva Yojna to be open to private hospitals
Health insurance in the country remains to be abysmally low, with both the Central Government and State Governments working towards improving its penetration in the country. The mediclaim scheme in Goa, which was previously applicable to government hospitals could now be open to private hospitals as well. The Deen Dayal Swasthya Seva Yojna or DDSSY is a universal mediclaim scheme which covers around 447 procedures. Under the old form, only around 200 procedures were eligible for treatment in private hospitals, with these hospitals requesting the government to provide them a free hand to treat all the ailments.
A new proposal put forth by the assembly aims to empanel hospitals, with it likely to be implemented on Independence Day. A review of the scheme is set for next year. The new insurance scheme, in its current form does not cover ailments like piles, fever, common cold, hernia, etc. The DDSSY scheme offers cashless hospitalisation to members, with a cover of Rs. 2.5 lakh provided to families with up to 3 members and Rs. 4 lakh to families with more than 4 members. Treatments which exceed the limit could be covered under the mediclaim scheme, with legislators working towards speedy implementation of the same.
1st August 2016
Life insurance companies cannot offer indemnity-based health products
The Insurance Regulatory and Development Authority of India recently sent out a circular asking life insurance companies to stop offering indemnity-based health products. As per the new policy, insurers can no longer provide these products. Indemnity-based policies account for around 90% of the health insurance segment, with the new crackdown likely to have a huge impact on business. An indemnity-based plan is one wherein a policyholder is entitled to reimbursements after availing a check-up from a doctor. Insurers have been asked to give policyholders a notice of three months before withdrawing them, with all existing contracts eligible to be continued till their policy term ends.
IRDA has suggested providing combo products which can combine the benefits of both a life insurance policy and a health insurance policy. This is in stark contrast to the previous policy wherein only pure life terms could be merged with health insurance.
28th July 2016
New health insurance scheme launched by Repco Bank
Repatriates Co-agent Finance and Development Bank or Repco as its commonly known, recently launched two new products for the market. Titled ‘Repco Medicinal Services’ and ‘Repco Home Consideration’, these products are aimed at providing a comprehensive healthcare package to individuals. While the medicinal services package offers complete family protection at affordable rates, the home consideration service offers protection solutions for household items. Individuals can avail protection for as low as Rs. 400 per year, with the primary intention of the bank being to provide universal protection to all involved.
26th July 2016
Star Health Insurance increases the cover under its cardiac policy in Chennai
New benefits have been added to the existing ‘Cardiac Care’ insurance policy by Star Health and Allied Insurance Company Ltd, without the requirement of any additional premium payment. The new benefits include CABG (Coronary Artery Bypass Graft and PTCA (Percutaneous Transluminal Coronary Angioplasty) extended to seven years prior to the commencement of the policy. The other features included are out-patient expenses ranging from Rs. 150 to Rs. 1500 for every policy period. Policyholders can get reimbursements under this policy only for expenses at Star network hospitals and diagnostic centres.
Additionally, customers can also get personal accident cover equalling the amount insured for accidental death in the health insurance policy. Health insurance cover will be given to customers with prior medical screening. Individuals who have undergone cardiac surgery can benefit from this revision. This new health insurance cover is available as two plans, namely Gold and Silver. The cover extended varies according to the plan chosen by the customer. Reimbursements for cardiac ailments can be availed by policyholders after 90 days from the commencement of the first policy.
22nd July 2016
Government employees might get health insurance benefits in Goa
The Goa Chief Minister, Laxmikant Parsekar said that the benefits under the Deen Dayal Swasthya Seva Yojana (DDSSY) will be extended to Government employees soon. This was announced at a launch ceremony where DDSSY health insurance cards were distributed. The Chief Minister also added that Goa would be the first state to include all of its citizens under one health insurance scheme. The scheme might be extended to offer assistance to up to Rs. 4 lakhs for customers. The Deputy Chief Minister, Francis D’Souza added that the Government would be investing Rs. 140 crore to implement this scheme.
20th July 2016
An all-inclusive insurance plan for migrant workers in Kerala
A comprehensive health insurance scheme will be introduced by the LDF Government in Kerala targeting around 25 lakh migrant labourers. This decision was announced by the Chief Minister, Pinarayi Vijayan. The new scheme “Awas” would be the registry and database for migrant workers in the state. The Chief Minister said that residence mapping would also be done for them in order to get their address and other details. The Kerala Government would also be conducting medical camps for these migrant workers as part of other welfare activities.
19th July 2016
AMMAOI wants Ayurveda to be included under health insurance plans
The Ayush department has been asked to include cover for Ayurveda treatments by the Ayurvedic Medicine Manufacturers Association of India (AMMAOI). A delegation from AMMAOI has requested the Prime Minister to help address this issue. Talks have been initiated by the Ayush department with eleven national insurance companies to cover Ayurveda under health insurance plans. The AMMAOI delegation to the Prime Minister included AMMAOI President S G Ramesh Warrier, AMMOI General Secretary D Ramanathan and P R Krishna Kumar. The Prime Minister has assured the delegation that all the necessary steps would be taken to consider this proposal.
18th July 2016
Data bank of fraudulent insurance claims to be prepared
An increase in the number of insurance claims has also resulted in a rise in number of fraudulent cases which are put forth, with companies facing losses due to such claims. In a bid to streamline the process and reduce the number of such false claims, the General Insurance Council of India has decided to create a data bank of all fraudulent claims, helping all stakeholders take precautionary steps in the future. In addition to the data bank, the council will also work towards creating standardised policies for commercial insurance and establishing a clearing house to monitor and resolve disputes between companies.
While the council has established procedures when it comes to regulatory issues, confusion has persisted in terms of other aspects. With the FDI in insurance increased to 49%, the council aims to enforce better guidelines to ensure the interests of everyone involved are protected. The data bank on fraudulent cases will be established with the help of insurers, who have experience in handling such cases. The data bank is likely to be complete in around six months, with insurers having access to this information. Experts hope that this data bank will help in establishing a pattern on such false claims, thereby benefitting the industry as a whole. Current indications estimate that 1 in 10 claims is false, which means that insurers spend time and resources verifying the authenticity of a claim, which should be reduced when the system goes live.
15th July 2016
Cover for health insurance plan in Uttarakhand to be increased
The 2nd phase of the Mukhyamantri Swasthya Beema Yojana (MSBY) will be launched on August 1st by the Uttarakhand Government. This phase will include the extension of the health insurance cover from Rs. 50,000 to Rs. 1.75 lakhs. This scheme can be availed by non-Government employees who do fall under any income tax slab. Pensioners and Government employees will not be included under this scheme. During the first phase, families enrolled under the scheme could get cashless hospitalisation for up to Rs. 50,000. Under the Mukhyamantri Swasthya Beema Yojana (MSBY), 10,80,000 families have been enrolled. This health insurance scheme will have a tertiary care cover for Rs. 1.25 lakhs per family and a base cover of Rs. 50,000 for medical treatments. With the tender process being completed, the scheme will also offer cover for 600 diseases and the tertiary care cover will offer protection for heart and kidney ailments along with complex medical treatments.
14th July 2016
Certificate of registration provided to Aditya Birla Health Insurance
The Health Insurance sector in the country has seen tremendous improvement over the years, with a number of prominent companies entering this business. The latest conglomerate aiming for a share of this sector is Aditya Birla Health Insurance, who were recently awarded the “Certificate of Registration” by the Insurance Regulatory and Development Authority of India (IRDAI). This essentially means that the company is now one step closer towards starting its operations.
The company will be a subsidiary of Aditya Birla Nuvo and will offer health insurance products as regulated by IRDAI. In addition to Aditya Birla Health Insurance, Edelweiss General Insurance Company also received a registration certificate from IRDAI.
13th July 2016
Students impacted by dengue could get free insurance cover
In good news for thousands of government students, local health authorities in Gurgaon have decided to offer a health insurance cover to protect students who have been impacted by dengue. This new policy, which is likely to be implemented from July 22 onwards, will provide a health cover of Rs. 25,000 per student towards the treatment of dengue at any government hospital. It is said that over 20,000 students studying in around 600 government schools will be benefitted through this new policy. The primary motive behind introducing this policy was to ensure that students affected with dengue get the right treatment, which might not be possible due to lack of funds in certain cases.
A premium of Rs. 150 will be paid towards maintaining this policy, with the government finding private sponsors to pay this amount. Developed under the PPP or Public-Private Partnership model, the scheme will ensure that the health of children is not impacted due to dengue, providing them adequate support to tackle the problem. Both pre and post-hospitalisation charges will be covered by the scheme, with formalities yet to be finalised.
12th July 2016
Students impacted by dengue could get free insurance cover
In good news for thousands of government students, local health authorities in Gurgaon have decided to offer a health insurance cover to protect students who have been impacted by dengue. This new policy, which is likely to be implemented from July 22 onwards, will provide a health cover of Rs. 25,000 per student towards the treatment of dengue at any government hospital. It is said that over 20,000 students studying in around 600 government schools will be benefitted through this new policy. The primary motive behind introducing this policy was to ensure that students affected with dengue get the right treatment, which might not be possible due to lack of funds in certain cases.
A premium of Rs. 150 will be paid towards maintaining this policy, with the government finding private sponsors to pay this amount. Developed under the PPP or Public-Private Partnership model, the scheme will ensure that the health of children is not impacted due to dengue, providing them adequate support to tackle the problem. Both pre and post-hospitalisation charges will be covered by the scheme, with formalities yet to be finalised.
12th July 2016
Tamil Nadu government renews health insurance for government staff
The Tamil Nadu government recently renewed the health insurance cover for government employees, choosing to enhance the policy by introducing new cover. The new policy covers organ transplant surgeries and cancer treatment as well, in addition to the regular cover. The employees will now have cover up to 2020, with the policy up for renewal after 4 years.
The government will provide a cover of Rs. 7.5 lakh to government employees who are covered under the Chief Minister’s Comprehensive Health Insurance Scheme. Employees who have dependents with up to 40% beneficiaries can protect their interests under this scheme, with a minimum premium of Rs. 180 to be paid every month. The local government will be investing around Rs. 17.90 crore towards securing the health of its employees under this scheme, which covers around 10.22 lakh employees.
11th July 2016
Odisha Government to launch a new health insurance scheme for drivers
Biju Gadi Chalak Bima Yojana, a new health insurance scheme will be introduced by the Odisha Government for drivers in the state. This scheme would cover medical treatments and death due to road accidents. Planning is underway for the health insurance scheme, with aspects like premium, etc., being decided. Health insurance companies across the state would have to be included into the scheme. Auto rickshaw drivers and truck drivers would be able to enrol under this scheme.
7th July 2016
Cashless treatment is the primary requirement for health insurance customers: Survey
According to a survey published by Liberty Videocon General Insurance, the top requirement for health insurance policyholders was cashless treatment. 96% of the respondents said that they would require this with the survey being done across the four metro cities. However, the survey also showed that awareness of health insurance also remained low, despite efforts from companies. Around 93% of the survey respondents told that they bought health insurance to cover hospitalisation expenses. While taking a health insurance plan, customers seek the following features - good network of hospitals, cashless treatment and cover for pre and post medical treatment.
About 48% preferred family policies over individual health plans and the deciding factors were cover and pricing for 86% of the respondents. 84% of the customers in Delhi bought health insurance plans to save on tax, with the number being 23% in Kochi.
5th July 2016
IRDAI asks insurers to file business data for social sectors and rural areas
The Insurance Regulatory and Development Authority of India (IRDAI) has asked all insurance companies to furnish data regarding their businesses in social sectors and rural areas. This has been requested to ensure that insurers are completing the required tasks in these areas. Life insurance companies have to submit the number of policies availed in rural areas and the percentage share they carry in the total policy bucket. With respect to the social sector, life insurers have to also furnish data about the number of lives covered. Health insurance and general insurance companies have to submit the premium amount collected in rural areas and also show how it adds up to the gross premium. Business data for the social sector would also be required from them.
Insurance companies have to submit an annual certificate in the name of the Principal Officer or the CEO as per the IRDAI (Obligations of Insurers to Rural and Social Sectors) Regulations, 2015. Health insurance companies have to show a 2% gross premium collection from rural areas during the first year and then 7% in the tenth year.
5th July 2016
Aam Aadmi Party (AAP) to introduce a health insurance plan covering all Delhi citizens
The Aam Aadmi Party (AAP) has announced a new health insurance scheme to include all the citizens in New Delhi. This policy will be introduced the upcoming year with a coverage of Rs. 10 lakhs. Policyholders can get treatments at empanelled private hospitals and all Government hospitals in the Capital. With the proposal in the final stage, the scheme will be launched through the Society for Universal Healthcare in Delhi. The premium that has to be paid would be a very small amount and the Government would be making the premium payment for the economically weaker section.
A Request For Qualification (RFQ) has been opened by the department to invite insurers to bid for the health insurance scheme. The new health insurance scheme will offer protection for common diseases, accidents and other life-threatening conditions. This will be introduced along the lines of schemes like Delhi Arogya Nidhi and Delhi Arogya Kosh. This new scheme will cost the Delhi Government around Rs. 500 crores. Some of the Senior Health officials are looking to include heart diseases, cancer and brain-related conditions in the new health insurance policy.
4th July 2016
91% of Indians are without health insurance coverage for short and long term health emergencies
According to a recent survey by HDFC Life, around 91% of Indians do not have a health insurance scheme to their name. This includes no existence of health insurance for both short and long term health contingencies. The aim of the survey was to capture the health planning status of Indians and to see whether they monitor their health regularly and how do they modify their health plans if they do monitor.
The overall health planning index stood at 40.1 on a scale of 100 which signifies that India still has a long way to go when it comes to efficient and effective health planning. Only 9% of the population has a health insurance covering them for both short and long term illness. Critical illness (of friends and family members) was the single major contributor to people changing their health planning pattern. The survey revealed that planning for health became better with growing age. Only 11% of those who have health insurance plans review them regularly and keep them updated. Another key finding of the survey is that health planning is similar in tier 1 and tier 2 cities.
1st July 2016
Insurance premium across the country has increased by 7.9% in 2015
With non-life and life insurance products gaining momentum, insurance premium collection across the country has increased by 7.9%. The rate at which insurance premiums increased was higher than the previous year. The increase can be attributed to the performance of non-life and life insurance products. Life premium collection increased by 7.8% and non-life insurance premium grew by 8.1%. This growth in premium collection saw contributions from motor third party liability insurance, personal accident insurance and health insurance. Economic growth and policy initiatives from the Government are expected to improve insurance penetration across the country.
30th June 2016
IndiaFirst Life Insurance and Star Health Insurance collaborate for offering insurance plans
IndiaFirst Life Insurance and Star Health and Allied Insurance have signed a deal to introduce Star First Combi Plans. These new plans will be a combination of life insurance and health insurance plans. A suite of five plans will be offered under the Star First Combi Plan providing dual benefits from life and health insurance. An important feature would be life insurance cover for the policyholder in addition to a health insurance cover. The family of the policyholder would also be covered under this plan.
30th June 2016
Aditya Birla Financial Services Extends its Reach to the Health Insurance Segment
Aditya Birla Financial Services will be extending health insurance products through Aditya Birla Wellness Private Ltd. Company. This new company would fall under the ownership of the Aditya Birla Financial Services and MMI Holdings, a South African financial service provider. After Aditya Birla Nuvo had announced this extension in its service offerings, the market share value of the company has gone up by 3.47%. The competitors of Aditya Birla Wellness Private Ltd. Company would be leading health insurance provider such as – TATA AIG, Bharti Axa, etc.
29th June 2016
CM’s Health Insurance Scheme Benefits a 5-year old, Grants Him the Gift of Speech and Sound
The Chief Minister’s Comprehensive Health Insurance Scheme (Tamil Nadu) has given a new lease of life to a 5-year old boy by gifting him with the sense of speech and sound for the first time. It was truly a dream come true for young Ifshth and his father Abdul Hakkim, a vendor. The boy’s father told reporters about the Chief Minister’s Comprehensive Health Insurance Scheme (CHIS) advertisement which he came across in a local newspaper. The young child was admitted to the PSG Hospital in for a cochlear implant and was among the first 35 children to be registered with the hospital under the CHIS scheme for the treatment. the treatment which otherwise would have cost the parent a whopping Rs 8 lakh, was done without any charge, as the same is covered under the CMs Health insurance scheme.
28th June 2016
PM Modi suggests using Yoga to stay healthy
International Yoga Day was celebrated with great fervour in Chandigarh, with the Prime Minister, Mr. Narendra Modi leading over 30,000 participants in a yoga demonstration. Participants included members of the armed forces, school children, university students and politicians. A believer and follower in the concept of yoga, Mr. Modi suggested the use of asanas to stay healthy, stressing on the use of yoga to treat diseases, especially diabetes. With the country home to a huge number of diabetes patients, Mr. Modi recommended yoga practice to prevent and control cases, helping people stay healthy and fit, with yoga acting as a natural health insurance scheme to combat this widespread ailment.
Mr. Modi requested yoga trainers and practitioners to use yoga for holistic development, hoping to tackle a different ailment next year. In addition to this, he also announced two awards connected to yoga, one of which would be given at the international level and the other at the national level. A special stamp commemorating the Surya Namaskar was also released before the event, with the HRD Ministry organising a Yoga Olympiad which saw school children from 21 states participate in it.
21st June 2016
DHFL Pramerica Life Insurance Introduces Online Only Health Plan for Dengue
With the objective to expand its presence in the health insurance segment with affordable online mass market products, DHFL Pramerica Life Insurance recently launched its first purely online direct to customer product called DHFL Pramerica Dengue Shield. The Dengue Shield is a traditional fixed benefit individual health insurance plan which has been introduced by DHFL. For the purpose of the launch, DHFL has entered into an agreement with ItzCash, one of the foremost companies to offer holistic payment solutions. ItzCash has been roped in to help raise customer awareness toward the need of a cover like Dengue Shield.
Being an online only product, the DHFL Pramerica Dengue Shield can be purchased online only. It is one of the most affordable products which is available at a premium beginning from as low as Re 1 per day (subject to certain policies). For added convenience, customers who don't’ have access to internet facilities can also buy the products through ItzCash touch points.
16th June 2016
Price and coverage play key roles in purchase of health insurance plans
According to a survey done by Liberty Videocon General Insurance, health insurance buyers choose policies based on pricing and coverage. Health insurance has become a priority for urban India. Purchasers in India generally get health insurance policies for critical illness like cancer, pregnancy and diabetes. Salaried individuals aged between 25 and 45 years have been buying health insurance policies recently. The survey saw participation from insurance advisors from New Delhi, Mumbai, Kochi, Bangalore, Coimbatore and Ahmedabad. As per the advisors, New Delhi has the maximum number of individuals buying health insurance, followed by Mumbai. Cities like Kochi and Bangalore showed lesser health insurance awareness. Under health insurance, buyers preferred whole family coverage better than individual plans. The main reason to avail health insurance was to cover hospitalisation expenses. Network hospitals and cashless treatment benefits were also major factors determining the type of health insurance plan to be purchased.
16th June 2016
The share purchase transaction between Bupa and Max India Ltd., has been concluded
Max India Ltd., and Healthcare group Bupa announced that the transaction to increment Bupa’s shareholding in the Max Bupa health insurance joint venture was completed. Bupa’s share has been increased from 26% to 49%. This move was done due to changes in India’s foreign direct investment (FDI) regulations, which allows foreign investors to own up to 49%. In the health insurance sector, Bupa is the first foreign investor to apply for an increase in shareholding. An amount of Rs. 207 crore has been paid by Bupa to Max India to complete the transaction. The Insurance Regulatory and Development Authority of India (IRDAI) gave the required regulatory clearance to conclude the transaction. In India, Max Bupa is the seventh largest private health insurer with a customer base of over 2 million policyholders.
15th June 2016
Goans are now eligible to avail health insurance if they have completed five years of residence
Deputy Chief Minister, Francis D'Souza announced that Goans who have resided in the state for five years or above and also own an Aadhaar Card can now procure health insurance policies under the Deen Dayal Swasthya Seva Yojana (DDSSY). Migrants to the state will also be included under this scheme. The DDSSY scheme was being launched by the Deputy Chief Minister at the Candolim primary health centre. Candolim PHC health officer, Brenda Pinto, Calangute MLA, Michael Lobo, Sarpanch Sandra Fialho, Arpora-Nagoa sarpanch Mahima Korgaonkar, Parra Sarpanch Delilah Lobo and Zilla Panchayat member Shawn Martins were present at the launch. The DDSSY cards would be manufactured by Goa Electronics Limited (GEL), with the GEL Chairman also attending the event.
14th June 2016
Medical Insurance will be offered for Delhiites by the Government
The Delhi Cabinet, along with CM Arvind Kejriwal, has approved the introduction of a health insurance scheme all Delhiites. According to Delhi Health Minister Satyendar Jain, the same will become a reality by the end of 2016. It should empanel government and private hospitals as well. The scheme will entail payment of premium in three categories: the highest payment will not be more than Rs 3,000 per year. The government will pay the premium for those below poverty line. There will also be private healthcare opened for those who have not been able to afford them.
14th June 2016
IRDAI: Force must not be used to obtain discharge voucher
General insurance companies has been directed by regulator IRDAI to not use force or coercion on insured persons to attain receipts of settlement of claims or discharge vouchers. Discharge voucher is the result of insurance claim, which proves that payment has been done. IRDAI has said that the present system of obtaining the discharge voucher may be continued as long as there are no disputes by the claimant/s or insured/s to the amount offered by the insurer towards settlement of a claim.
13th June 2016
Health Insurance Scheme may be reviewed as per Private Hospitals’ Performance
Goa Health Minister Mr Francis D’Souza has said that his government is willing to review rates of health insurance policies under the Deen Dayal Swasthya Seva Yojana provided private hospitals show good output through the scheme and prove efficient performance. The process of selecting private hospitals under the scheme will be done solely by the United India Insurance Company with the state government having no say in the matter. The new insurance scheme is set to be implemented from this Independence Day, 15th of August. The overall financial implication through the scheme is likely to hover between Rs.100 crores and Rs.125 crores, with 50% of the overall money expected to be spent on government hospitals.
8th June 2016
HDFC Ergo moves to own L&T General Insurance in deal
HDFC Ergo has announced its move to buy L&T General Insurance in a deal valued at a little over Rs.550 crores. The deal will be an all cash transaction and is the first such deal concerning merger of two insurance companies in India. Post-acquisition, all employees of L&T General Insurance will be retained. HDFC Ergo is currently the fourth largest private general insurance company in India with more than 100 offices and over 2,000 employees spread throughout the country.
The whole process is likely to be completed in the next 11 months and will have HDFC Ergo owning 100% stake in L&T’s general insurance arm, which has an employee strength of over 800 and has been operational since the last 6 years. L&T GI’s assets, values at over Rs.600 crores now, will be added to HDFC Ergo’s balance sheet once the acquisition is completed.
7th June 2016
Jharkhand state government plans to provide medical insurance for BPL families
Jharkhand Chief Minister Raghubar Das announced his government’s plan to launch medical insurance worth Rs.2 lakhs for Below Poverty Line (BPL) people residing in the state. This is for treatment of serious ailments. Apart from this, these people will also get a medical insurance of Rs 50,000 for treatment of common diseases.
There has been a further announcement of starting dialysis facility in 8 districts of Jharkhand, within a couple of songs. BPL families who earn Rs.72,000 annually can avail free dialysis facility too. The government has further assured that this facility will be available in the entire district of Jharkhand within the next 6 months. As another progressive step, seven nursing colleges will be opened in the Jharkhand soon, and tribal women will be trained in nursing and given work.
6th June 2016
Bajaj Allianz General Insurance reports high profit for FY 2015-2016
Bajaj Allianz General Insurance has reported a high profit for the financial year 2015- 2016. The net profit that has been reported is Rs. 564 Crores and there is an 11% hike in the Gross Written Premium, to that which was reported in the financial year 2014 – 2016. The health insurance segment has made a significant contribution to this growth in sales. The solvency ratio of the company was 182% in the financial year 2014 – 2015 and currently, it is 251%. This further assures customers of the company’s claim paying ability.
6th June 2016
Deen Dayal Swasthya Seva Yojana Launched by Parrikar in Goa
The flagship scheme of the Goa government, the Deen Dayal Swasthya Seva Yojana, has been launched by Defence Minister Manohar Parrikar at Kala Academy. At the event, Mr Parrikar said that the government has managed to fulfil most of its promises given at the time of elections to the people of Goa. This includes the introduction of schemes such as Ladli Laxmi, Graham Aadhar, Old Age scheme, etc. by the government in power in Goa. The schemes were carefully chosen and introduced after studying the social problems as an effort to counter them.
3rd June 2016
BPL families to get new social security system
Families living below the poverty line could have something to cheer in the coming year, with the government planning to adopt a new social security platform for them. A proposal to implement the new platform from the next financial year is currently floating around, with the government aiming to combine all current benefits into a single plan. This new platform will aim to transfer all benefits available under different schemes directly to BPL families, with a health insurance cover of Rs 1 lakh proposed by the Finance Ministry. If implemented, it will offer protection against serious illnesses and will materialise the vision of Finance Minister Mr. Arun Jaitley. The plan would be a great addition to the current schemes like Pradhan Mantri Jiwan Jyoti Yojana and Pradhan Mantri Suraksha Bima Yojana, which provide life and accident cover, respectively.
2nd June 2016
Universal Sompo General Insurance MD told to step down
The Managing Director of Universal Sompo General Insurance Company was recently asked by IRDAI to step down from his position. Mr. Taketoshi Nagaoka was ordered to vacate his position, with the Insurance Regulatory and Development Authority of India (IRDAI) asking Mr. O.N Singh, the chairman of the company to take charge until a new MD is appointed. The primary reason behind this request was to ensure compliance with new Foreign Direct Investment (FDI) rules which state that management control should lie with Indians.
Following this directive, Universal Sompo General Insurance has started a restructuring process, with a new management structure likely to be implemented soon. The company is planning to turn the position of Chairman into a non-executive one, with a search for a local CEO already on. Universal Sompo General Insurance has sought an extension to implement the recommended changes, hoping to sort things out by the end of July. A board meeting will be held by the company to chart out the way forward.
Sompo Japan Nipponkoa currently holds 26% stake in the company, with Allahabad Bank and Indian Overseas Bank being the other stakeholders. The Japanese firm is in talks to increase this stake, aiming to raise it to 49% in the next few months.
1st June 2016
IRDAI to keep eye on insurance discounts
With the number of companies offering high discounts on insurance products increasing, the Insurance Regulatory and Development Authority of India (IRDAI) has decided to keep an eye on them. High discounts can be seen in a number of segments, with group health insurance topping the charts in terms of discounts offered. IRDAI has asked insurance providers to follow new norms, ensuring higher solvency is maintained, especially in the popular segments like health and motor insurance. This higher solvency ratio is to be maintained by companies offering motor, liability and health insurance.
IRDAI has already asked insurers to stop providing high discounts on premiums, but most companies continue to do so, in a bid to attract more customers. Increased competition is cited as the main reason to provide discounts to gain a wider consumer base.
31st May 2016
Insurance companies to monitor diet and fitness regimen
Insurance companies are all set to enforce strict health regulations, with a number of them keen on keeping an eye on the diet and fitness regimen of policyholders. The primary intention of doing this is to ensure that members who adhere to policy requirements get benefits, while those who fail to do so are treated accordingly. With stress and additional workload playing a key role in ailments, insurers want their clients to follow a healthy lifestyle, serving a dual purpose for both the company and a policyholder.
Policyholders who adhere to company requirements will be rewarded by insurers, with reduction in premiums working as their motivation factor to stay healthy. Failure to follow guidelines could see the premium cost increasing. A number of companies have joined forces with dieticians, doctors and gyms to ensure they can keep a close eye on the progress of their policyholders. In addition to this, companies are also offering discounts to policyholders who wish to use the services of said gyms, spas or salons.
30th May 2016
AYUSH treatments to fall under health cover
With AYUSH therapy gaining prominence in the country, the Central Government has issued directives to insurance providers to offer packages for these treatments. AYUSH, or Ayurveda, Yoga, Unani, Siddha and Homeopathy have found takers from across the globe, with India becoming a hub for alternative therapy. Most insurance policies do not cover AYUSH outpatient treatment, prompting complaints from practitioners and patients alike.
Post this directive, companies have ensured that they will make packages to cover AYUSH outpatient treatment, with Max Bupa, National Insurance, New India Assurance, Star Health Insurance and Apollo Munich taking steps towards implementing these changes. In addition to this, guidelines will be framed for such treatments, with the AYUSH Ministry joining forces with the National Accreditation Board for Hospitals and Healthcare Providers (NABH) to formulate policies.
AYUSH treatments in the past were not covered under conventional health insurance policies primarily due to the fact that most treatments did not involve hospitalisation, with AYUSH practitioners primarily relying on outpatient treatment. Additional cover for such traditional practices is bound to increase demand for AYUSH, providing a boost to the industry.
27th May 2016
Public sector banks to form alliances with various insurance companies
Starting April 1st, bancassurance was made feasible by the Insurance Regulatory and Development Authority of India (IRDA). Banks can now sign agreements with three non-life insurers, three life insurers and three health insurance companies. Public sector banks like Bank of Baroda, Canara Bank, Bank of India, Andhra Bank and Bank of Maharashtra have formed tie-ups with various insurers following this announcement. A bank can tie-up with a maximum of nine insurance companies to sell its insurance products.
Canara Bank, which promotes Canara HSBC OBC Life Insurance, would be entering into an agreement with a general health insurance company soon. Bank of Baroda and Star Health and Allied Insurance have formed an alliance to achieve a target premium of Rs. 3000 crores. Bank of Baroda would be also signing deals with other standalone health insurance, general and life insurance companies. Bank of India and Andhra Bank would be signing agreements with standalone health insurers as well.
25th May 2016
Insurers take to Twitter to reach out to Customers
Insurance companies in India are now using Twitter to engage with their policyholders, address queries and complaints. This route has been adapted by various insurers, as its gives them instant access to customers and also speeds up resolution times. Bajaj Allianz General Insurance has introduced #TweetInsurance @BajajAllianz to help customers get policy quotes, claim updates and also get policy documents online. Health insurance subscribers can use this twitter handle to get information on insurance branches and network hospitals.
@MaxLifeIns is the handle created by Max Life Insurance to offer policies, create awareness and also post ads. SBI Life Insurance uses the twitter handle @SBILife to promote campaigns and also educate customers on insurance. ICICI Lombard General Insurance offers advice on day-to-day home-based activities to customers and the need for insurance. The @ICICILombard twitter handle also provides information on travel destinations as it offers travel insurance. A health insurance provider, Cigna TTK Health Insurance offers dietary plans, health advice and exercise videos for its followers on Twitter.
24th May 2016
Deen Dayal Swasthya Seva (DDSS) to be functional from Aug 15
The Goa Government would be launching a new health insurance scheme, Deen Dayal Swasthya Seva (DDSS) on May 30th. This scheme would be operational and benefits can be availed only from August 15th. The DDSS scheme will be covering all types of conventional diseases, chronic and psychological conditions. Policyholders of the scheme admitted to medical institutions like Tata Memorial Hospital and AIIMS can get financial assistance for their treatments. The Goa Chief Minister, Laxmikant Parsekar is considering to expand this scheme into districts like Sindhudurg and Karwar too.
According to a circular given in the cabinet, this policy would include a cover of up to Rs. 2.5 lakhs per year for a family with three members or less. An insurance cover of up to Rs. 4 lakhs would be given for a family size of four and above. Goan residents can avail various health insurance benefits from the DDSS scheme. Government employees and their families will not be able to enrol under this scheme.
23rd May 2016
New solvency ratio margins determined by the IRDA
A new set of rules have been issued by the Insurance Regulatory and Development Authority of India (IRDA) to help companies maintain a solvency ratio depending on the type of business. Motor, health and liability sections will have to have a higher ratio, with claims and premiums being quite high. Aviation, fire and engineering can have a relatively lower ratio. Since the company would be considered to be financially dependable if the ratio was higher, all companies are required to maintain a minimum solvency ratio of 150%. In the group health segment, there might be hurdles regarding this due to discounts. Here, the solvency ratio will depend on the net incurred claims and the premium collected.
20th May 2016
IPO Guidelines Revision in Offing: IRDAI
IPO guidelines will be revised soon as the IRDAI looks set to issue new guidelines to help insurers tap the benefits of IPOs. In the last year, the insurance sector saw influx of Rs.15,000 in foreign investments as the government’s move to increase FDI in insurance came into force. The government passed the bill in March 2015 that increased foreign investment cap to 49% from 26%.
The life insurance sector meanwhile experienced growth at 12% in the last year, non-life sector at 14% while health insurance sector grew at 40%. With low penetration of insurance in the country, the sector has huge scope for improvement.
20th May 2016
IRDAI announces Revised Expense Norms for General Insurers
The IRDAI (The Insurance Regulatory and Development Authority of India) recently revised the norms regarding management related expenses for health insurance and general insurance companies. These revised norms which will come into effect from the current financial year.
Management related expense are charged to a company’s revenue account and usually refer to operating expenses like brokerage, commission, payments made to intermediaries / agents, etc. In segments like health retail, miscellaneous retail (e.g. public liability) and motor, the upper limit for expenses is slightly higher. However, from now on, non-adherence to the expense limits would attract penalty. Health and general insurance companies must keep their expenses within the allowed limits.
Motor insurance companies are allowed an expense of 37.5% of the total premium for the first Rs 500 crore. For the following Rs 250 crore, the allowed expense stands at 32.5%, while 30% is allowed for total premium of the remaining balance.
Non-observance of the revised expense norms set by IRDAI could result in a cutback of performance related incentives for officials like the CEO, whole time directors, managing director, members of the management, etc. Additionally, restrictions could also be placed on business expansion related activities (opening new branches / offices), selection of administrator or removal of management personnel.
19th May 2016
Standalone health insurance providers register an increase in market share
In the general insurance sector, individual health insurance providers have recorded a 41.2% growth for the year, 2015 - 2016. Private companies have been able to achieve a 13.1% growth, with public sector undertakings (PSUs) reaching 12.1%. The health insurance segment has registered the maximum number of claims and has also grown by 30%, as compared to other insurance products.
Star Health and Allied Insurance’s market share has incremented from 1.82% to 2.19% as per the General Insurance Council report. Market share for other insurers like Max BUPA Health Insurance has increased from 0.46% to 0.52%, for Apollo Munich Health Insurance from 1% to 1.12%, for Religare Health Insurance from 0.34% to 0.55% and for Cigna TTK Health Insurance from 0.03% to 0.16%. Under the PSU category, United India Insurance and New India has a slight growth in market share.
A private general insurer, ICICI Lombard General Insurance, has also recorded a growth in market share from 8.29% to 8.84%, based on its motor and health insurance products. The gross direct premium income for the insurance industry grew from Rs. 80,583.59 crore to Rs. 91,572.25 crore for the year, 2015 - 2016.
17th May 2016
Preventive Check-ups Preferred by Women Health Insurance Buyers
A recent survey by Bajaj Allianz General Insurance has revealed that more than 1/3rd of women buyers of health insurance policies prefer plans that offer cover for preventive health check-ups. 1/3rd of the participants in the survey also preferred maternity cover with their plans while 28% were looking for lifestyle diseases cover in their policies.
Other insights from the survey shows that only 15% of overall respondents had a health cover, with major reasons for not buying such plans being - felt no need to buy a policy (40%), unaware about available plans (25%), already a part of policy (20%), full family not covered (10%) and higher cost of premiums (5%).
17th May 2016
The government of Goa will soon launch health insurance scheme
Francis D'Souza, Deputy Chief Minister of Goa has announced that the state government will soon be launching a Health Insurance Scheme called Dayanand Universal Health Insurance Scheme. This scheme will benefit residents of Goa. Those who have been living in Goa for more than five years will receive the health cards. The healthcare needs of the people will be attended to. The scheme has been moulded by Goa State Branch and Institute of Nursing Education at Bambolim. Another project of the government soon to be implemented is beginning a 500-bed super specialty hospital.
This project is expected to aid over 447 intervening ailments which includes diabetes. It is not just hospitals in Goa which will be involved in the project but also some reputed hospitals from outside Goa. Government and private hospitals in Goa will be involved as well. United India Insurance Company Limited is the insurance company chosen by the government to support the project. Rs 120 crore has been put aside for this purpose.
16th May 2016
Health Insurance premium payments can now be done in parts
Going forward, health insurance policy holders will be able to make partial payments of their annual premium. This move to introduce part payments of health insurance premium has been done to improve the reach of health insurance policies across India. According to the Insurance Regulatory and Development Authority of India, insurers have to get prior approval, if they plan to launch such kind of part-payment schemes. Private companies have already adapted the move and are looking into options to implement the same. In order to get people to avail health insurance in India, the Finance Minister, Mr. Arun Jaitley has also increased the tax deduction limit under Section 80D to Rs. 25,000 from Rs. 15,000. The tax deduction limit has also been increased for senior citizens from Rs. 30,000 to Rs. 20,000.
13th May 2016
Star Health and Allied Insurance makes Bank of Baroda its bancassurance partner
Star Health and Allied Insurance has signed an agreement with Bank of Baroda making the lender its bancassurance partner. This move has been implemented to promote insurance products at Bank of Baroda branches. This tie-up will help Star Health to tap into Bank of Baroda’s vast clientele of 60 million customers at over 5000 branches. Bank of Baroda aims to achieve a premium target of Rs. 3000 crore through this understanding. More than 2000 trained professionals would be assisting in taking Star Health products to the market, going forward.
12th May 2016
Insurance Ombudsman Disposes 92% Cases in 2015-16
The Insurance Ombudsman of India has disposed 92% of the grievance cases received in 2015-16 as compared to the 78% from 2014-15. The Ombudsman intention to enhance awareness at its 17 centres across the country has gained momentum thanks to no backlogs, larger settlements and faster disposal as revealed by the Insurance Ombudsman’s office which is responsible for managing claims associated with housing, motor, life, personal accident and health insurance. The Pondicherry and Tamil Nadu office, in particular, has witnessed a 100% settlement of cases in the past few years, with 1,170 cases being cleared during 2015-16 and 1,527 in 2014-15.
11th May 2016
Private Insurance Providers to Form Part of MSBY
The State health department (Uttarakhand) is considering the inclusion of private insurance providers in the Mukhyamantri Swasthya Bima Yojana – the ambitious global health scheme. The department was not able to choose the insurance provider for the comprehensive health insurance scheme over the past few months, but Dr. Prem Lal, the Director and In-charge of the scheme recently revealed that the department has readied a proposal which will include private general insurance providers in the process of the tender that will be sent to the government. The tender process will commence once the government has provided its approval on the same.
11th May 2016
Health insurance scheme specially designed for weavers
The Government has issued certain guidelines regarding the implementation of health insurance schemes that are being specially designed for weavers. The health insurance schemes for weavers are being launched under Rashtriya Swasthya Bima Yojana, a health insurance plan for the poorer sections of the society.
According to the guidelines issued by the government, the health insurance scheme for handloom weavers will be launched by the Ministry of Health and Family Welfare for this financial year and the Ministry of Textiles will be providing the budget for it. Every state will implement the plan on the same norms as Rashtriya Swasthya Bima Yojana scheme by including the beneficiaries stated by the Ministry of Textiles.
The Government has also instructed the State Governments implementing the schemes to ensure that there is no duplication of benefits to the same beneficiaries from the RSBY and Handloom Weavers Health Insurance scheme. The Handloom weavers under BPL categories (in 19 states) which implemented RSBY scheme in 2015-2016 are already covered under the scheme.
10th May 2016
ESI Plan May be Included in Mega Health Shield Scheme
The health protection scheme announced by Finance Minister Arun Jaitley that provides a cover of Rs. 1 lakh for a family may also include the ESI or Employees’ State Insurance medical plan according to sources. With this inclusion, the benefits will extend to more than 10 crore people.
According to a senior official, ESI is a parallel scheme by the government and already boasts of a large base of users and hence is trying to merge it with the Mega Health Shield. It will allow ESI policyholders to procure health insurance from places that have been registered under a health protection scheme. In addition to a coverage of a lakh, a top-up of Rs. 30,000 will be given to senior citizens. The Health Ministry will also negotiate with the numerous state governments so as to merge state run schemes into the universal health scheme. In cases of additional protection, the state can contribute the additional premium amount.
The government plans to launch this scheme by the end of this year and in the second phase, plans to expand the user base by including other state and central sponsored health plans. According to sources, this matter is currently under discussion and the health ministry has been requested to draw up a proposal on the same and will be evaluated by the PMO. This move is important as a number of health insurance schemes in India is by the public sector.
9th May 2016
Survey shows that Indians are not Prepared for Medical Emergencies
A survey conducted by Ipsos, on behalf of Cigna TTK Health Insurance, has revealed that the average Indian is completely unprepared for medical emergencies. The survey was conducted on a sample size of about 3,200 people from various countries and it required them to rank physical, family, work, financial and social wellbeing in terms of importance. In the survey, it was revealed that Indians rated physical wellbeing as the most important to them. However, further examinations revealed that more than half the Indian participants had ended up paying for medical expenses from their own money, indicating that they were not using insurance.
In fact, only 26% of also indicated that they would be covered by health insurance once they retire. Other data that lent support to this revelation was the fact that while 89% said they would take care of their parents’ health, only 70% said that they were doing fine in this regard. The survey concluded that Indians are not prepared for medical emergencies and will continue to pay for medical care from their pockets in the future as well.
6th May 2016
Max Bupa slapped with Rs.20 lakh penalty by IRDA
The IRDAI has accused the Max Bupa Health Insurance Company of four violations, one of which is related to the claim-settlement timeline. The insurer has been accused of not properly recording the claim intimation date in the system. For this, they have been slapped with a penalty of Rs.5 lakh.
Another Rs.5 lakh penalty adds to this because of the violations relating to the sale of unapproved plans. The company launched a new version of an insurance scheme which was under review by the IRDA, and sold this before the approval was completed. The company also sold previous versions of the plan while the new version was under review by the IRDA. The insurer also engaged the services of vendors for the generation of leads, and this has cost them another Rs.5 lakh in penalties.
Many experts believe that the IRDA is being too lenient with insurers who default on the IRDA’s guidelines, and that this is a small step in the right direction – as the IRDA exists to regulate insurers so that Indian citizens get the best protection possible without worrying about malpractice on the part of the insurer.
5th May 2016
Max Bupa Wins IT Management Best Practices Award
Max Bupa, the health insurance provider, has been awarded the IT Management Best Practices award at the Celent Model Insurer Asia Awards 2016, making this their third win. The award is presented to those insurance companies that make the most of technology integration into their services so as to effect optimal distribution of products and smoother customer management. The award has been given in recognition of the company’s efforts towards making the customer experience more convenient with the implementation of a new CRM model. Speaking at the occasion Ashish Mehrotra, the MD & CEO of the company said that the award was a testament to their continued efforts to make services available to their customers by leveraging the technology available.
4th May 2016
IRDAI requests Insurers to Refrain from Entering into Pacts on an International Basis
Refusing to rework on the current norms, IRDAI has instructed insurers to not enter into reinsurance agreements on a global level with foreign companies wherein they do not have much of a say. Insurance Regulatory and Development Authority of India or IRDAI, as it is commonly known, received many requests from insurance companies seeking the waiver of provisions of IRDA Regulation 2013.
The companies requested exemption on the lines of execution of reinsurance treaties on a worldwide level, where the Indian company along with the promoter company from abroad would enter into a reinsurance agreement with multiple reinsures.
IRDAI observed that, in such arrangements, the Indian company would not have much of a say in vital decision making on matters such as terms of treaty, reinsurer choice and so on. Therefore, the compliance of numerous regulations and provisions would not be possible for the Indian companies.
IRDAI has also requested general insurance and standalone health insurance companies along with GIC Re to comply with the IRDA Regulation 2013 and revisions/amendments to that. The regulator also observed that all reinsurance related needs of Indian companies may differ from that of their foreign counterpart. In addition to this, the conditions, terms, claims and exclusions of these underlying products may also vary from one company to another.
29th April 2016
Insurance companies tie up with small banks!
Insurance companies in India are coming up with new measures to widen their reach and in one of their new moves, the companies have decided to tie up with small banks. MFIs and co-op banks in order to widen their reach and sell more of their products through these new institutions.
The concentration of insurance companies and their touch points in urban areas was recently pointed out in a recent meeting by the Insurance Regulatory and Developmental Authority of India. Owing to their strong branch presence, state owned insurers rule the rural markets. IRDAI has instructed banks to tie up with multiple insurers and act as agents.
Future Generali India Insurance, one of the well-known insurance provider in the country has tied up with over 10 small and medium banks in Kolhapur and Sangli district in order to distribute rural and micro insurance. Cigna TTK health insurance has tied up with the country’s largest urban co-operative bank Saraswat Bank which in turn will strengthen its presence in six states. 80% of the country does not have health insurance policy and this new move might enable insurance providers to provide insurance to everyone.
28th April 2016
Maharashtra’s Cashless Insurance Scheme fails to make an Impact
An Assembly Committee recently pointed out a few flaws in Rajiv Gandhi Jeevandayee Arogya Yojana which might explain why Cashless health insurance is not working out for the economically backward part of the society in Maharashtra. The committee pointed out that the critical equipments such as pacemakers, stents and valves which are used to treat patients are of cheap quality and in turn can affect the health of patients.
The committee stated that it has been receiving complaints from patients who recently went through angioplasty and bypass about problems faced by them after the surgery. This is said to be because of the poor quality of the equipment. The committee also discovered that poor patients were not treated at all in certain hospitals and medical centres. Some of the hospitals refuse to implement the RGJAY scheme despite getting all facilities from the government and this in turn is affecting the economically backward classes.
27th April 2016
80 Percent of Indians do not have Health Insurance
As per a survey conducted by NSSO, it has been found out that 86 percent of people in the rural areas and 82 percent in urban areas did not have any health insurance cover, neither public nor private. It has been observed that most depend on savings or household income to fund health related expenses, sometimes even borrowing in order to meet hospitalization and other medical related expenses. This survey also confirms the fact that India is one of the most privatized systems in the world for healthcare with people opting for ‘out of pocket’ expenditure for medical expenses.
It has also been found out that some of those from the lower economic strata in rural areas resort to selling their possessions in order to pay for medical expenses and over 5 percent look for help from their family and friends. The recent survey echoes earlier studies conducted in the domain regarding the financial strain placed on people due to medical expenses and are known to be one of the main causes for accumulation of debt.
The reach of most private insurance companies have also been noted to be very limited with just 12 percent of the highest income customers procuring the same. The numbers in other segments were almost negligible. However, due to many government programs such as Rashtriya Swasthya Bima Yojana, around 12 percent of urban and 13 percent of rural population could be brought under health coverage.
Through the survey it is also known that a majority still opt for healthcare services from private players placing them under a heavy financial burden, also the reimbursement of expenses regarding hospitalization was not done always.
25th April 2016
Proposal to Provide Health Insurance for Domestic Helps
The Labour Ministry is working on a proposal to provide medical insurance to domestic helps and their families for low premium amounts. A Labour Ministry source said the scheme would not be mandatory, but employers of domestic maids and drivers would be encouraged to contribute towards a health insurance policy for those working for them. The plan is to develop a health insurance scheme that will cost only Rs. 250 as premium.
The government plans to start with covering domestic helps under the Employees’ State Insurance (ESI) scheme. Following this, they would be included under the Employees’ Provident Fund (EPF) scheme.
The proposal is in line with the Central Government’s vision of providing comprehensive social security cover to domestic workers in the country. The government is also reportedly working on a domestic workers’ policy that will mandate that employers and workers have to enter into work contracts. This would help cover them under the EPF and ESI schemes.
22nd April 2016
Madhya Pradesh shows Poor Track Record for Reimbursement of Medical Claims
Madhya Pradesh adds another item to its list of woes and shortcomings. Not only is the state a poor place for medical treatment but records show the state to be have one of the worst track records when it comes to reimbursing medical expenses
According to the latest report carried out by the National Survey Sample Office (NSSO), only six people per thousand patients have received a reimbursement either in part or in full in the entire state.
This comes as a shocker due to the higher end of average medical expenses incurred especially in rural areas where the average cost of medical treatment stood at Rs 18,696 and in January to June of 2014, the number of expenses that were reimbursed in rural MP either in part or in full was one patient per thousand patients.
19th April 2016
Cigna TTK looks to Revamp Health Insurance Purchases and Sales
Cigna TTK, one of the leading standalone health insurance companies are looking to revamp and simplify the process of purchasing health insurance and are aiming to make the process more engaging with the policyholders
Cigna TTK, in their efforts have launched a personal health wallet which serves the dual purpose of encouraging people to acquire health insurance policies whilst keeping them motivated stay fit and healthy. Sandeep Patel, CEO and MD of Cigna TTK Health Insurance Company said that the wallet aims to educate people about being healthy and fit and know about their insurance needs and also said that the company is currently working on ideas that can provide incentives for fitness related activities on a daily basis such as a particular discount on premiums for completing a certain distance through walking on a particular day
Cigna TTK has also recently launched the ProHealth Accumulate which is a product that enables the creation of a personal health wallet that can be used as a reserve to meet future healthcare expenses.
19th April 2016
30,000 Ludhiana Traders to Get Health Insurance Smart Cards
More than 30,000 Ludhiana traders will soon get smart cards under the Bhagat Puran Singh Health Insurance Scheme. Registration for the scheme has begun and the cards are due for distribution by April 19. While over 20,000 traders in the district have registered themselves under the scheme already, 10,000 smart cards have been issued and reached the Excise and Taxation Department.
Under the Bhagat Puran Singh Health Insurance Scheme, beneficiaries can get hospital care of up to Rs. 50,000 in more than 400 hospitals – both private and government – of the state. The scheme also give the family Rs. 5 lakh as compensation if the head of family dies in an accident or becomes disabled.
18th April 2016
State Health Insurance Schemes Benefited 80,000 Cardiac Patients in 2015
Data from around 630 cardiac centres in the country has revealed that heart patients who get stents implanted is far higher in Andhra Pradesh, Telangana, Karnataka and Tamil Nadu compared to other parts of the country because of state health insurance benefits.
According to the Cardiological Society of India (CSI), the four states helped around 80,000 patients (23 percent) get free stents among a total of 3.75 lakh angioplasty patients in 2015. Dr. NN Khanna, chairman, CSI’s NIC-2016, said health insurance schemes on the lines of Aarogyasri, available in the above four states and Rajasthan, makes better healthcare accessible to rural patients. Because of these schemes, there has been a 6 percent increase – from 17% in 2014 to 23% in 2015 – in BPL patients getting free stents, he said.
18th April 2016
Cigna TTK launches Health Savings Scheme ‘ProHealth Accumulate’
There have been savings schemes offered from life insurers that allow a return of premium but there hasn’t been any kind of a savings scheme offered from a health insurer. Cigna TTK, a standalone health insurer aims to change that by providing a health insurance plan that banks on the contributions of the policyholder and also provides an opportunity to earn interest on the deposit made.
While traditional health insurers have avoided comprehensive health care and outpatient costs primarily because of the vulnerability to fraud, ProHealth Accumulate from Cigna TTK aims to change that. Under this plan, a person will be contributing towards an individual or floater Health Reserve wallet that would take of future medical expenses without unnecessarily bothering the policyholder.
The added benefit comes from the guaranteed 5% return that will be offered on the deposit amount. Policyholders can opt for a range of cover starting from INR 5000 and ending at INR 20000 to cover outpatient expenses like consultation, pharmacy expenses, diagnostic tests and even alternative medicines. Coverage for dental treatment, contact lenses, cost of reading glasses and hearing aids is also provided under this product. The product offers a sum assured amount that ranges from INR 5.5 lakhs to INR 25 lakhs.
15th April 2016
Autistic Children to be covered by a Star Health Policy
Private insurer Star Health and Allied Insurance has initiated a health insurance policy in Chennai that aims to address the needs of autistic children and it is the only second policy in India that features such a target group. The Nirmaya insurance scheme from the Central government is the only other insurance policy in place that caters to autistic children.
The scheme has been launched by the company by insuring 241 children from the Chennai based NGO ‘Sankalp’. For a period of 1 year, the health concerns of the children will be covered by Star Health till a maximum sum insured of INR 1 lakh.
13th April 2016
High Number of People Not Covered by Health Insurance, According to NSS
More than 80% of the Indian population does not have cover under any health insurance policy, according to data released earlier this week by the latest NSS (National Sample Survey). The data shows that despite the fact that the RSBY (Rashtriya Swasthya Bima Yojana) has been in progress for the past seven years, only 13% of the rural population and 12% of urban residents had access to insurance protection.
Data from the survey also showed that around 82% of the urban population and 86% of rural residents did not have cover under any scheme that supports health expenditure. Moreover, the survey also showed that coverage and living standards are correlated. So far as urban areas are concerned, more than 90% pf the poorest residents did not have any insurance cover while 66% of the richest residents also sailed in the same boat. The report suggests that the poorer household are either unaware of such coverage, or they simply cannot afford it, in both urban as well as rural areas.
12th April 2016
State Health Insurance now covers Diabetic Insulin in Goa
As revealed by the Deen dayal Swasthya Seva Yojana, the scheme that covers 443 illnesses, diabetic insulin will also be covered under the state sponsored health insurance scheme in Goa. Registration of beneficiaries will be done within a year that will help people avail the benefits of the scheme in a more effective manner. The scheme is extended to the resident population of Goa, or basically people who have resided in there for a period of five years or more.
State-run insurers will be taking part in the bidding on May 25 and post the process of selecting the insurers, the beneficiaries will be taking part in a registration for this health insurance scheme. The scheme will cover 3 lakh families from the state, especially the 15 lakh population of Goa. The plan would cover the entire family that is subscribed to the scheme and will include the household head and other members. The insurance cover will provide an amount of INR 2.5 lakh for a family of three or less. For a family of four or more, the insurance cover is INR 4 lakhs.
11th April 2016
Startups to Receive Dedicated Products from Health Insurance Giants
In a move that follows in the recent steps of SBI, HDFC, RBL Bank and Federal Bank, ICICI Bank’s insurance subsidiary ICICI Lombard has announced that it is now offering dedicated products to startup ventures. This initiative was taken to move with the times, especially in regards to the startup market domestically. Vice president Birendra Mohanty, SME & Broking, ICICI Lombard GIC, stated that a health insurance policy has been designed for startup ventures with more specifically designed products coming up on the horizon. As of now the initiative has been introduced in a fairly low-key manner, said those who are aware of these recent developments.
6th April 2016
CM’s Health Insurance Scheme Lacks Patronage of Government Hospitals in TN
In Tamil Nadu, the funds allotted for the government medical insurance scheme is underutilized by a whopping 25% with more than 46 government hospitals out of the 89 not even using the funds allotted for this scheme
The woeful utilization of funds came to light after a health rights activist, C Anandraj, filed for an RTI to check the progress of the health insurance scheme introduced by the chief minister was faring in the nine southern districts of the state
Only 43 of the 89 hospitals have been utilizing the funds allotted for this scheme that benefits both hospitals and patients alike. The scheme had some success in 2013 with Madurai district generating Rs 2.27 crore with this scheme but mismanagement saw this number fall by Rs 85 Lakhs to Rs 1.42 crore in 2014.
4th April 2016
Universal Health Insurance - ‘Aam Aadmi Swasthya Bima Yojana’ for Delhi
Delhi government has planned to launch a health insurance scheme for the inhabitants that is termed as the Aam Aadmi Swasthya Bima Yojana. This plan is projected to cover around 40 lakh families that are not present in the income group of ‘Request for Qualification’ according to major health insurers. The plan is supposed to cover families for four years in its initial stage.
The plan though launched exclusively for the aforementioned income group, will also be available for higher income groups provided they pay the required amount of premium that is stipulated by the government. All government hospitals and some private healthcare facilities will be empanelled through the project and a minimum of around 1700 packages of hospitalisation are expected during the course of the contract with the government.
The projected cost of the plan is around INR 500 crores annually. The health insurance primarily looks to provide coverage for diseases like cancer and neurological disorders which are cost intensive in terms of treatment. The project is supposed to be a framework that supports existing provisions like Delhi Arogya Nidhi and the Rashtriya Swasthya Bima Yojana. This is a move carried out by the Delhi Dialogue Commission, a policy think tank associated with the government of Delhi.
31st March 2016
IRDA hopes to see rise in health insurance nationwide
A report released by the IRDA showed that the health insurance industry has seen a growth only in the five states - Maharashtra, Tamil Nadu, Karnataka, Delhi and Gujarat. According to the Insurance Regulatory and Development Authority (IRDA), these states have been contributing 71% of the total premium. The remaining 31 states and union territories contributed only 29%.
Maharashtra, being the highest contributor added Rs 6,575 crore (33%) of the total premium, while the combined premium from the eight north-eastern states was amounted to Rs 158 crore (0.79%) for the financial year 2014-15. There has been a marginal improvement from last year's contribution where the north eastern states contributed around Rs 118 crore (0.60%). It is dampening to know that in spite of the North Eastern states having highest literacy rate, the awareness regarding health insurance is comparatively low.
There has been a remarkable increase in the penetration of health insurance in the markets of the top five states. In Karnataka there was a 20% hike in premiums that amounted to Rs 2,123 crore from the previous year. Rashtriya Swasthya Bima Yojna (RSBY), which is the national health insurance programme for unorganized workers is implemented in 30 districts in Karnataka - including Ballari and Chikmagalur. In case of group medi-claims, Maharashtra was leading with Rs 3,468 crore, while Karnataka that came second contributed Rs 1,521 crore.
29th March 2016
TPAs can now process health claims for foreigners - IRDAI
In a historical decision, the Insurance Regulatory and Development Authority of India has allowed Third Party Administrators to process insurance claims of foreigners who have taken policy from an Indian insurance provider. IRDAI also stated that an insurance provider can engage multiple TPAs for offering health services to its policyholders in the same way as one TPA can offer services to multiple insurance companies.
IRDAI has asked insurance providers and TPAs to ensure all applicable discounts from hospitals get passed to the policyholders. Cases where the sum insured is less than the actual claim being made, there, the hospital will have to take into account the applicable discount before extracting the differential amount from the policyholder. In the same way, policies that have co-payment option or deductible, for those the discount should first be applied and then the co-payment or deductible must be applied.
There have been cases where TPAs have forced customers to go one particular hospital, IRDAI has asked such TPAs to refrain from doing so and to not indirectly coerce people to switch from one insurance provider to another. Influencing policyholders to go to a hospital of TPAs choice is not a good approach.
28th March 2016
Health Insurance TPA to begin its Operations from next Fiscal
In house health claims are set for a makeover, with the Health Insurance TPA all set to manage them from the next fiscal. A joint venture floated by public sector insurance companies, Health Insurance TPA will handle around 10% of the claims, which are currently being handled by external agencies. A pilot project to check its working will be launched in the capital in October, with phased expansion based on performance.
The primary objective of Health Insurance TPA is to improve efficiency by lowering the turnaround time for a claim, with offices being provided by New India Assurance Company, United India Insurance Company, Oriental Insurance Company and National Insurance Company, who each have a 23.75 stake in Health Insurance TPA, while General Insurance Corporation of India has a 5% stake in it. In addition to this TPA, existing external TPAs will continue to work on claims as well.
Health Insurance TPA will handle both reimbursement and cashless claims, with cashless claims requiring pre-authorisation. The company aims to launch a mobile app to simplify the entire process. TPA will also offer additional services like verification, investigation, empanelment and pre-policy health checks.
26th March 2016
Plans to increase awareness about Bhamashah Health Insurance Scheme
With the Bhamashah Health Insurance Scheme launched by the Rajasthan Government last year failing to generate the expected response, the state government has come up with a host of new measures to popularise it. The scheme which aims to provide health cover to families living below the poverty line has over 400 private hospitals under its network, with members eligible for treatment in any of these hospitals. The ambitious scheme which aims to provide protection to over 67% of the population has roped in ration shops and folk artists to spread the word. All relevant information about the scheme will be provided to ration shops, with folk artists popularising it through street plays and local songs.
The plan provides an insurance cover of Rs 30,000 for general and Rs 3 lakhs for serious ailments to each family enrolled under it. Ration shops will educate members of the public about the provisions of the scheme, including the treatments which are available for free. A comprehensive action plan is being prepared by the government to ensure that the benefits of this scheme are passed on to the needy.
22nd March 2016
RTE students may also receive health insurance coverage
The Primary and Secondary Education Department Minister, Kimmane Ratnakar said that student under the Right to Education, may also receive health insurance coverage. The Education Department is working towards this inclusion. There will be no discrimination against any students. The government is expected to announce a health insurance to all students who are below the age of 18 years, and are studying in government schools and colleges or those that are aided by the government. The Department has received over 451 applications to set up PU colleges and more than 800 colleges for starting high schools. Along with this the Education Department will also provide pair of shoes and two pairs of socks to all government school students and will also ensure that the funds set aside for these provisions are not misused.
16th March 2016
Only 80% of Health Insurance Policies Renewed in 2014-15
The Insurance Regulatory and Development Authority of India (IRDAI) has revealed that only 80.7 percent of all health insurance policies were renewed during the fiscal year 2014-15. This means that instead of the 92.67 lakh policies that were due for renewal, only 74.79 lakh policies were renewed during the year.
A release by the Ministry of Health and Family Welfare said that factors such as affordability of the premium could have forced policy holders to let go of the health insurance. Health insurance policies fall under the ambit of the different regulatory provisions in vogue, such as IRDA (Health Insurance) Regulations, 2013, and IRDA (Protection of Policyholders Interests) Regulations, 2002. IRDA insists that the policy holder must have the freedom of choice before they decide to buy an insurance policy.
Non-life insurance companies provide more than 600 IRDA-approved health insurance products. Their features include cover for domestic hospitalisation, hospitalisation during overseas travel, accidental temporary or permanent disability, defined critical illnesses and accidental death. The products are marketed not only through individual agents, but also through corporate agents, banks and other institutions, policy brokers, online sale, direct sale, etc.
14th March, 2016
IT enabled National Health Protection Scheme by 2017
Now, insurance coverage of up to Rs. 1 lakh will be provided to the socially and economically backward people of the country. The Ministry of Health has prepared a plan of Rs. 15,000 crore, and hope to roll out National Health Protection Scheme in the coming year. The allocation of budget for the scheme was Rs. 1,500 crore with an annual spending of Rs 4,500 crore. The health budget received a 21% hike from the previous year. This scheme was proposed at the Budget 2016, keeping in mind the Socio-Economic Caste Census list, and will be made applicable to people who are part of this list. Health Minister J P Nadda, said that people who have want this and need it can opt for the scheme, but primarily this will be available for the socially and economically backward section of our society. The plan is to roll out the scheme in 2017, the initial corpus of funds which are allocated, will be used to set up a platform that is IT enabled.
9th March, 2016
Large Gaps in Indian Health protection System
India, which is home to the second largest population in the world has one of the largest health protection gaps in Asia, which according to experts is bound to go up by around 12.3% every year, reaching $214 billion by the year 2020. Technically speaking, the health protection gap is the difference between the costs which are needed to provide healthcare needs in the country versus the costs which are available to account for these costs. The report by Swiss Re indicates that there could be a $43 billion lacuna in the healthcare costs in India, which would necessarily mean that Indians spend more from their own pockets.
Statistics indicate that less than 23% of the population has a health insurance cover, with government schemes accounting for a majority of the policies. The report also stated that 60% of the overall healthcare expenses were met by individuals, with the insurance plans having minimal contribution. Given that only 288 million people in the country have health insurance, there is huge scope for companies to offer better products, getting more people under their fold by 2020. Experts predict a 100% increase in health insurance penetration within the next 4 years.
04th March 2016
New health insurance scheme for all to be implemented by Govt. of India
The Union Budget for 2016-2017 brought some cheer to those living below the poverty line, thanks to an announcement by Finance Minister Arun Jaitley stating that a new health insurance scheme will be implemented by the government. This scheme aims to provide health insurance to BPL members, with a cover of Rs 1 lakh for each family. Apart from members of the BPL community, senior citizens over the age of 60 years will get an additional top-up worth Rs 30,000. The scheme aims to improve the health of the poor, ensuring that their health issues are addressed and they receive necessary treatment.
Currently BPL families are covered by the Rashtriya Swasthya Bima Yojana (RSBY), which offers cover of Rs 30,000 on hospitalisation. This new initiative is bound to improve the overall health scenario in the country, promoting financial inclusion and encompassing more people. Under the RSBY scheme, a nominal registration of Rs 30 was to be paid by beneficiaries, with the Central and state governments paying the actual premium for insurance. With families under the BPL finding it hard to make ends meet, registering under the new health insurance scheme can alleviate some of their worries.
1st March 2016
Health Insurance Plan to be implemented by Delhi Government
The Delhi Government is all set to implement a health insurance scheme in the Capital, offering a health cover at a reasonable amount. The plan is likely to be rolled out this year, with it covering medical expenses to the tune of Rs. 4 lakh per person. A premium of Rs. 3,000 per year will be charged to avail the benefits of this plan, covering treatment for critical illness at government hospitals in the capital.
15th February 2016
ICICI Lombard, Bajaj Allianz and others Include Yoga in Their Healthcare and Wellness Package for HEalth Insurance
Indian insurance providers such as ICICI Lombard, Bajaj ALlianz and others have started including Yoga as a part of their Healthcare and Wellness packages in health insurance policies. This is mainly due to the growing global popularity of this ancient wellness activity, which was originated from India itself.
Despite the fact that this is something that has been observed in the employee's' group health insurance schemes, some insurers are currently planning to include it for their retail health policies too. Nikhil Apte, CPO, Royal Sundaram, "We are planning to introduce such programmes for our retail customers," who are also planning to offer online Yoga coaching sessions or DVDs to its retail policyholders.
28th January 2016
Health insurance and diagnostic to be taxed
The goods and services tax bill is unclear and certain sectors of the health care are clouded with uncertainties. The inverted duty structure might be removed or made available as a refund. The duty charged on the health care equipment that is imported will be made available as a credit. The exemptions that the healthcare sector enjoys, may or may not stay the same after the GST is passed. The healthcare and diagnostic services will see a higher tax burden under the bill.
25th January 2016
Proposal to offer free healthcare and insurance to the poor households
Proposal for free healthcare and life insurance is to be offered to the 100 million extremely poor households in India. This proposal leads to every 10 household in India having access to free medical and life insurance while the remaining will get health and life insurance schemes with annual cover of Rs.50,000 and Rs.2 lakh under Jeevan Jyoti Yojana scheme. The other suggestion made was to provide mandatory fortification of staple food items. The other suggestion was to make 300 essential drugs easily available and for free of cost at government hospitals.
25th January 2016
Fitness Discount from IRDAI on Health Insurance Policies
The Insurance Regulatory and Development Authority of India (IRDA) has proposed that health insurers can offer discounts towards renewal premiums for people who maintain good wellness and fitness.
IRDA released the draft of Health Insurance Regulation 2016 which notifies general insurers to promote fitness and wellness among policyholders through health-oriented services like outpatient treatments or consultations, health check-ups, pharmaceuticals or discounts etc. at specific network providers. These additional costs are to be incorporated in the base health insurance policy premiums.
In terms of senior citizens, the premier agency has directed transparent, justified, fair and disclosed products to be sold to them. Insurers are also being directed to disclose loading charges as cleared on top of the premium amount. For these expenses, insurers should get consent from policyholders. A distinct channel for grievances and claims of senior citizens has also been proposed.
IRDA has also outlined the regulations for ‘combi products’ which will involve both life insurance and health insurance components, with one of the partner insurers acting as the ‘lead’ insurer.
21st January, 2016
Third Phase of Health Insurance Scheme “Shravak Arogyam” Launched for Jains
The Jain Community, led by the Jain International Organisation launched the third phase of a health insurance scheme, “Shravak Arogyam” to protect the health of Jains in the country. This phase of the scheme has been designed keeping the social security and healthcare of the Jain community in mind, offering great benefits at affordable rates. Doctors of the Jain Doctors Association will manage the health program which has over 30,000 members already. This scheme will offer comprehensive healthcare to the community right from birth up to the entire duration of their life. Apart from the health benefits involved, members will also be entitled to tax benefits under Section 80D of the Income Tax Act.
13th January, 2016
2% rise in complaints against health insurers
The number of customer complaints increased by 2% in 2015 over the previous year. 7000 complaints were registered in 2014-2015. The industry blamed lack of understanding as the main reason for the spike. 47% complaints we claim- related and 33% were policy related. The industry believes that the ROHINI initiative will improve things in the future as it will make things transparent and will clear the misunderstandings between the insured and insurers. The industry however saw a decline in complaints reported under motor insurance segment.
11th January, 2016
Universal Health Insurance scheme on the anvil
The Government of India is working on a universal health insurance plan for the country, hoping to build a healthy nation. Talks for this new scheme are on, with the success of the life and accident cover plans boosting the hopes of the government. The proposed scheme will aim to integrate the current cashless heath programs in different states with the Direct Benefits Transfer (DBT) platform of the Centre. This integration hopes to simplify access and talks are on with states which are currently offering cashless health insurance. Certain states like Gujarat, Karnataka and Tamil Nadu already have local health insurance policy in place and the centre aims to provide a platform in the form of DBT for such schemes.
Modern technology will be utilised during every step, with an app on the anvil, aiming for a cashless digital procedure. Two organisations, the National Payments Corporation of India and the Public Financial Management System will provide assistance in disbursement of health subsidies under the plan. Aadhar and Jan Dhan details will be made available to the states, with the hope that biometric identities can be verified by Aadhar and Jan Dhan bank accounts can be used to transfer funds directly.
30th December, 2015
Unique Health Insurance Scheme for Cops’ Kin launched in Arunachal Pradesh
Nabam Tuki, the chief minister of Arunachal Pradesh announced the 'Arunachal Pradesh Chief Minister Universal Health Insurance Scheme' at the 43rd raising day Arunachal Pradesh Police (APP). This unique health scheme can be availed by family members of the state police. The chief minister has asked police officials to enroll each and every member of their families in the scheme, stressing on the collective enrolment of officials posted in remote areas.
Addressing the gathering at Rajiv Gandhi Stadium on Sunday, November 08, 2015, he encouraged SPs and commandants to facilitate the health scheme enrolment process. In a statement, he also said the education of one child of every policeman will be funded by the state government, in case the child opts for higher education outside the state.
13th November 2015
General insurance companies fret over heavy discounts
Heavy discounts offered in the group health insurance continue to be a source of worry for general insurance companies. Though Insurance Regulatory and Development Authority of India (IRDAI) has asked insurers to refrain from giving out discounts, high premium-related incentives are still being offered.
According to experts, the group health space is suffering due unhealthy competition in the market, and prices are as low as 25-35% that is lesser than previous year, despite many claims. In order to retain large corporate clients or to attract them with better rates heavy discounts are offered. Due to this reason, a number of private insurers are exiting or cutting down on the insurance business due to discounts.
12th November 2015
Pensions and health insurance for senior journalists
The National Journalist Welfare Board (NJWB) has decided to distribute pensions and health insurance covers to senior journalists. To be distributed on National Press Day, which falls on November 16, family members of accredited journalists will also be covered in this scheme.
In a statement released by NJWB’s State president Pradosh Patnaik and vice-president Pradyumna Mohanty said that the Press Day would be organised at the Jayadev Bhawan from 3.30 pm to 10 pm. It is a joint effort by the Door Darshan, the All India Radio, Press Information Bureau (PIB) and the ‘Amit’ under the direct guidance of the NJWB.
On this occasion, senior journalist Barendra Krushna Das will be conferred with ‘Utkal Sambadik Ratna’. Editors of five newspapers from other States will be honored with ‘Rashtriya Sambadik Gourab’. Students from Utkal University and Utkal University of Culture will also be felicitated with the ‘Rabinarayan Mohanty Smaraki Samman’ and ‘Gopal Mishra Smaraki Samman’, respectively on that day.
Presided over by Loksevak Mandal chief and NJWB national president Deepak Malavya, Press Day is expected to be attended by many eminent personalities from different fields like bureaucracy, judiciary, and politics. Several competitive events are also planned to be organised on the occasion.
11th November 2015
Future Generali plans to expand health insurance business
Future Generali India plans increase its health insurance premium by 50%, from its retail business. The general insurer also has plans to launch new products and expand its channel in the next two years. In the last fiscal year, health insurance premium recorded the value at around Rs. 200 crore and the retail business arm reported a 22% gain.
According to a statement released by the head of retail, the company is looking improve on its non-motor insurance business, since health insurance is gaining popularity in the country. Out of the Rs. 1400 crore recorded in the last fiscal year through March 2015, around 14% came from health insurance (which includes personal accident) and travel insurance.
Including Health Total, which is a new product, the company at present has six health insurance products. It is also planning to launch three more products in travel insurance segment once the approval from the regulatory board comes through.
2nd November 2015
General Insurance may not reach its target of Rs. 1 trillion for 2015
The premium growth of the general insurance may not reach the target growth it’s target of Rs. 1 trillion, despite registering double digit growth in the current fiscal year. The industry had closed last year of 2014-15 with a total premium of Rs 87,000 crore, the Motor and health, insurance which have been generally driving the growth, has shown more growth in the second half of the year. The four major public sector general insurers namely New India Assurance, National Insurance, United India Insurance and Oriental Insurance have shown a better growth than their peers in the private sector.
26th October 2015
Jains of Mumbai set to enjoy community-level health insurance
A new insurance policy specially aimed at meeting health insurance needs of Jains settled in Mumbai is soon to hit the floor. The Jain Community that looks after the most basic needs of Jains in the city mentioned that they had been researching about the medical insurance needs of the Jain community and the idea is to change the dynamics of how insurance if offered to customers in the country. The insurance policy aims to offer better targeted insurance deals to members of a particular community. The community also launched a closed group mobile offer for Jains in the financial capital.
22nd October 2015
Health Insurance Yojna from December 13 in Rajasthan
The Rajasthan government has decided to launch a cashless medical facility for the public, from December 13, 2015. Named Health Insurance Yojna, this scheme has an insurance cover of Rs. 3 lakhs for every family. There will be a provision of Rs. 30,000 for medical insurance and Rs. 3 lakhs for serious diseases.
Vasundhara Raje, the Chief Minister of the state, said that the pre-trial for this scheme will be flagged on October 26 and the full-fledged one will be officially launched from December 13. The beneficiaries for this scheme will be decided on the basis of Aadhar or Ration Card. According to the Medical and Health Minister R S Rathore, the state government has decided to spend Rs. 300 crore on health insurance for around one crore families residing in the state.
20th October 2015
Long Term Health Insurance in India
Insurance has always been a sore subject in India, with a low percentage of the populous actually knowing about it and an even lower percentage which takes initiatives to avail an insurance. The stark contrast between 7% insured assets and 80% insured assets in India and the USA respectively is clearly visible. Health insurance is one of those aspects that most people in India do not give a serious thought to. Renewals in one year terms also brings about a refrain arising from time constraints and busy work schedule.
In a move to address this issue, a proposal is being considered by the Insurance Regulatory and Development Authority of India. Upon being finalised, this will allow people to purchase health insurances that could have validity periods for as long as 3 years. The increase in the limits on foreign direct investment in health insurance companies have opened up a more conducive path for insurers to move in favour of long-term health insurance as well.
12th October 2015
Karnataka State Health Department to provide free health insurance to the poor
A scheme offering free medical insurance for secondary care is being offered by the State Health Department. The scheme is still pending for cabinet approval. The scheme will have free medical care & specialized consultative care for surgery and treatment of seven major ailments. The plan is to introduce this scheme early next years after approvals, in both government and private hospitals in the state, and as a pilot in Dakshina Kannada and Davanagere districts.
7th October 2015
IRDA will consider company’s overall financial position for listing approval for health insurers
Insurance Regulatory and Development Authority of India said they will look into the financial position of a company overall before public issue of shares by health, reinsurance and non-life insurers. They will look into the record regulatory and its capital structure post issue, prior to giving approval. The time period of the business of the non-life insurance business, standalone health insurance business and reinsurance business will also be considered.
29th September 2015
Health Insurance to be more affordable for Persons with Disabilities (PwDs)
A memorandum of understanding has been signed between the New India Assurance Company Limited and the Department of Empowerment of Persons with Disabilities, Ministry of Social Justice and Empowerment for a new health insurance scheme. The scheme in question is the Swavalamban Health Insurance Scheme for PwD, this scheme is designed to provide cover for the beneficiary and their family. A single premium across the age of 18 - 65 years with an income of less than Rs. 3, 00, 000 annually can be availed by PwDs.
Any individual with blindness or low vision, hearing disabilities, any mental illness disability of locomotor, leprosy-cured can avail this insurance plan and has been designed to provide affordable health insurance.
24th September 2015
Health Insurance Scheme for Employees by the Government of Punjab
Cashless health insurance has been implemented by many states in India and the latest state government to join the bandwagon is the Government of Punjab. In a bid to benefit over 6 lakh employees and pensioners, this new mode of health insurance will soon replace the medical bills reimbursement scheme that was in effect up until now.
More than 250 empanelled public and private hospitals have been roped in for this particular scheme and as per the Service Rules (Medical Attendance Rules 1940), employees and their dependents can avail health facilities without having to keep track of the bills for reimbursement. Treatment done outside the state will still be covered by a reimbursement scheme and within 15 days of the submission of medical claims, the insurer will provide for the necessary expenses done. Instead of the initial health cover of INR 3,00,000 per family, this health insurance scheme will now cover employees/pensioners and their dependents for an unlimited amount. The scheme is to be made compulsory for employees and pensioners and will be optional for All India Service Officers, serving and ex-judges of Punjab and Haryana High Court and serving and ex-MLAs.
18th September 2015
Free Medical Insurance for all OLA Drivers
One of the most popular personal transport service providers in India, Ola, recently announced its decision to offer free medical insurance for all its drivers. As per the announcement, a sum of Rs 200,000 shall be offered to all divers of Ola to take care of themselves and their family members against the rising medical expenses. The medical insurance offered by Ola will cover hospitalization and other medical costs. The company will also offer free health check-ups to drivers at every quarter.
This new initiative taken by Ola has already been operative in cities like Mumbai and Hyderabad and served a lot of its drivers. The same program is expected to be launched soon in Bangalore, Delhi, Kolkata, Pune and Chennai when all Ola drivers will enjoy free medical insurance. Ola has taken this move to help its drivers lead a comfortable and better life.
2nd September 2015
The Government’s New Brainchild - Universal Health Insurance Project
Intending to focus on preventive health care rather than hospitalisation and treatment thereafter, the government of India is planning to launch a universal health insurance project.
Primary health care would be the main focus of this project, rather than hospitalisation and insurance benefits. Simple and sustainable primary health care with an increased public spending on the same is expected through this project, thus converting a larger portion of gross domestic product as opposed to a meagre 1.3% as of now.
Reportedly, schemes in Andhra Pradesh and Karnataka that offer cashless and immediate health care services to the poor and those in need have inspired this move.
26th August 2015
Revised Senior Citizens’ Red Carpet launched by Star Health Insurance
Star Health Insurance launched the revised Senior Citizens’ Red Carpet with the aim to enhance health insurance solution for the senior citizens of the country. Individuals between the ages of 60-75 years can purchase this policy. There is no pre-acceptance of medical screening required, irrespective of the age and the sum insured opted.
Medical consultation as an outpatient incurred in network hospital at Rs.200 per consultation and ranging from Rs.600 to Rs.1,400 per policy period is covered.
V Jagannathan, Chairman and Managing Director of Star Health and Allied Insurance said that with the increase in the cost and health care expenses, the best way to secure the senior citizens health is by purchasing a senior citizen insurance policy. He also added that the new Senior Citizens’ Red Carpet supports the senior citizens and help them live a healthier and a happy life.
21st August 2015
Government Steps In, Aiding Senior Citizen Health Care
The Government of India has stepped in to provide health insurance coverage for senior citizens in India, noting this age-group's dependency on their children and extended families for health and medical care. The lack of opportunity for health insurance for senior citizens from private sector insurance organizations has led to its further requirement.
For people over the age of 60 years, the scheme to be provided by the Government will help cover for secondary and tertiary health care for an amount up to Rs.1 lakh per annum. Secondary health care includes specialist care in better hospitals for treatment. Tertiary health care includes specialized consultation on reference from primary and secondary medical care centres.
People who fall in the BPL or Below Poverty Line bracket will be eligible for subsidiary in premiums for a health cover of up to 90%. This scheme will be available to BPL senior citizens will be over and above what they may have under the Rashtriya Swasthya Bima Yojana, which at the moment covers Rs.30,000 a year on the basis of family float, according to sources. This means the total sum assured can be used by single individual or jointly with members of the family.
A variant will also be available where the health insurance for senior citizens will cover Rs.1 lakh to a family, with a senior citizen member in it.
It is said to be finally announced by the Indian Prime Minister, Narendra Modi, when he addresses the nation this year on 15 August.
27th july 2015
Labour ministry extends health coverage to construction workers
In order to bring unorganised sector under the labour ministry’s purview, the government-led health coverage scheme, ESIC, will be extended to construction workers. ESIC, the Employees’ State Insurance Corporation scheme, currently covers employees in the organised sector e.g. office workers.
Underlining the importance of health insurance for this section of workers is the fact that the construction industry employs the second largest number of people in India. While office workers of construction companies are covered under the ESIC scheme, those who work on-site like construction workers were hitherto excluded from coverage. However, it has been noted that such on-site workers are more prone to ailments and accidents.
Construction workers who will be covered under this scheme will be privy to benefits such as financial protection in the event of death or disability, injury or ailment and even unemployment. Maternity benefits will also be provided.
The ESIC scheme is regulated by the Employees’ State Insurance Act, 1948. Workers with monthly wages upwards of Rs.15,000 are eligible for health insurance under this scheme.
23rd july 2015
The Era of Arbitrary Rejections of Health Insurance Claims Comes to an End
Following a recent move by the Insurance Regulatory and Development Authority of India (IRDAI), health insurance claims management will soon see quite a few reforms. Reforms that are aimed to bring in standardisation in claims settlement and reduce the policyholder’s pains in the process. Over time, a rise in dependence on third party administrators (TPAs) has led to increasing instances of discrepancies in claims settlement. Policyholders thus have had to bear the brunt of it all.
8th july 2015
IRDAI instructs health insurers to pass the discounts they avail from hospitals
Health insurers are to pass the discounts that they receive from the hospitals to the policyholders as per the IRDAI regulations. The insurers and the third party administrator has to ensure that the discounts are to be shown in the final hospitalization bill so that the policyholder will know how much the actual bill was. This move is to check the transparency in the system and also to bring parity in the health care costs in the long run. As per the industry experts, this move will benefit the insurance industry as a whole.
2nd july 2015
IRDAI plans huge changes in the health insurance sector
A level playing field for life & non-life insurers and more incentives for policyholders in the health insurance sector are some of the changes being mooted by the Insurance Regulatory and Development Authority of India (IRDAI).
There may be higher solvency requirement for the group health segment, IRDAI stated in its proposed draft norms on health insurance shared with various top companies. According to experts, players operating in the sector would have to henceforth allocate more funds. Industry-wise losses should be considered for product pricing, IRDAI had stated in its guidelines last year. Also, a policy should be formulated on the same approved by the board and closely monitored, IRDAI stated.
Currently, insurers have to maintain a solvency margin of 150 per cent at all times. According to experts, the margin for group health insurance is likely to go up further to 200 per cent, while retail medical insurance will continue with the existing limits. Policyholders in the health insurance sector can benefit from more incentives in that they can avail of better rates following proper monitoring of their fitness on a regular basis. The existing norms prevailing in the sector do not allow fitness levels to be the criterion for determining pricing owing to concerns regarding availability of inadequate and reliable data on the issue.
In addition to wellness incentives, insurers will be able to offer better insurance rates to consumers who maintain good fitness levels. Insurance companies are already providing wellness-based discounts such as gym membership discounts and spa coupons among many others for the benefit of customers.
According to industry officials, consumers who focus on their fitness can avail of more incentives. In terms of products, both life and non-life insurers may be provided equal space. Industry sources, however, admitted standalone health insurers will continue to offer niche products in the segment. Also, long-term critical illness plans may become more specialised in that more diseases and long-term products are expected to be added.
The aforementioned norms, in a draft stage, are expected to be finalised and implemented in the next few months.
19th June 2015
Health insurers to provide long-term savings plans
IRDAI which has set out to study the health insurance industry in India with a view to bring about necessary reforms, has come out with new recommendations. Under these, health insurance companies may now provide health plans that cover out-patient treatments and those that offer long-term savings plans.
Other recommendations include reforms in companies’ approval processes as well as how they define various terms related to their product offerings.
In terms of premiums, a recommendation was set out to peg premiums charged to inflation. Also, discounts could be offered with regards to premiums for preventive schemes or schemes aimed at promoting wellness. This is aimed at providing policyholders motivation to prevent major health issues thereby reducing overall individual health costs.
27th May 2015