IRDAI aims to simplify health insurance plans for Ayushman Bharat Scheme

IRDAI is pushing for simpler products and greater use of technology to increase the number of people covered by health insurance plans.

This is aimed at making the Ayushman Bharat-National Health Protection Mission (AB-NHPM) more accessible by people. The insurance regulator will work with health insurance companies under the public-private partnership model for AB-NHPM, popularly known as Modicare.

“With the increase in life expectancy in the country, the need for improving insurance penetration and coverage is paramount,” said Subhash Chandra Khuntia, chairman of IRDAI.

He said the “focus should be to make the process online, enhance use of technology, increase awareness and understanding about the insurance products.”

India’s health insurance industry has grown 16% cumulatively over the last 4-5 years. About 27% of the total insurance premium in the general insurance comes from health sector.

“There should be simplification and rationalization of health insurance products so that they are understood by a common people,” said Khuntia.

“Low risk awareness, lack of affordability and low understanding of the insurance products—these are some of the reasons why health insurance has not picked up so well even though the growth rate is high for the higher income group as a whole,” he added.

Under Ayushman Bharat, insurance companies will offer “standardized and simple products that are understandable to the policyholders”, Khuntia said. This, he added, would reduce cost, increase the efficiency and expand the coverage of the health insurance sector.

“The scheme would provide significant business opportunities for healthcare professionals including insurance companies and TPAs, package rates have been determined based on a thorough analysis and the scheme is designed to control fraud and abuse, among others,” said Indu Bhushan, chief executive at Ayushman Bharat. He said 28 states have currently joined the Ayushman Bharat scheme.