Health insurance set to get innovative

Notwithstanding presence of more than 24 health insurance companies, the Indian health insurance industry is still at a nascent stage compared with global peers. Globally, health insurance providers are much more advanced and have mature and developed products.

As the Indian health insurance segment matures, we are set to see coverage extend to more daycare treatments, global healthcare and preventive, as well as, wellness programmes in retail health insurance space. At present, innovations are limited to minor modifications on tariffs and features, add-on covers.

Although this industry is growing annually at a rate of 25-30 per cent, more innovations would benefit policyholders. We have already seen government initiation in form of state-level healthcare systems and Rashtriya Swasthya Bima Yojna.

Long-term benefit products: In India, innovation is limited to minor modifications on tariffs, features and add-on covers, such as dental cover and daily cash benefits for hospitalisation. India has to evolve from basic mediclaim to bridge this conspicuous gap in the portfolios of health insurers by introducing differentiated and multi-tiered long-term products. “The public-sector non-life insurance companies and a few life insurance companies have attempted to introduce health savings products. However, these products are not widely accepted partly due to their limited terms of coverage,” said Suresh Sugathan, head of health administration team at Bajaj Allianz General Insurance.

The recent developments show that health insurance is being discussed and new covers are being talked about. Growing economy, advancement in technology and rising health cost has highlighted the need for innovation in health insurance space.

Daycare treatment: Advancement in medical technology allows doctors to perform certain treatments within a day, which earlier used to require hospitalisation. This is also affecting health insurance, as policyholders need to check whether certain daycare treatments are covered in their policy or not. “As and when there is a new treatment included in daycare procedure, it gets covered by medical policies in advanced markets. This trend is slowly picking up in India as well, and soon we would see a lot of daycare treatments being covered by the health insurance plans,” said Sanjay Datta, chief of underwriting and claims at ICICI Lombard General Insurance.

Global health cover: To take care of overall health requirement, a global health cover may be implemented. “It offers unlimited worldwide coverage, can be used anywhere in the world and covers the most dangerous sports and occupations, including risk and war zones, all nationalities and moreover, provides freedom to choose hospitals and doctors.

“Such a cover is not possible for a country like ours in the current regulatory framework, but it can be one of the most innovative products for the Indian market,” said Neeraj Basur, chief financial officer of Max Bupa Health Insurance.

It would not only take care of the hospitalisation expenses, but also extend cover for maternity, dental, psychiatric illness, physiotherapy and other ailments.

Out-patient department cover: Globally, OPD cover is an essential element in the healthcare system. However, in India, the cover is limited or abscent. While it has been pointed out many times that out of the total healthcare cost, almost 70-80 per cent account for only OPD related expenses, it still remains to come under comprehensive health insurance cover. “This is a very relevant cover and it is available in all developed markets. Insurers are seriously contemplating about this product and we might see such covers in next few years,” said G Srinivasan, CMD of The New India Assurance.

Wellness and preventive diagnosis cover: While health insurance takes care of the costs incurred on actual hospitalisation, insurance companies might also take steps to prevent the occurrence of disease. “In countries like South Africa, insurers provide cover for preventive health checkups and diagnostic tests. This helps in bringing down the cost for insurers as the incidents of hospitalisation are reduced significantly,” added Datta.

Cover for lifestyle-related disease: The growing affluence of the Indian middle class, accompanied with lifestyle-related diseases and inflationary healthcare costs, are driving the demand for health insurance. This drastic increase in lifestyle diseases, particularly cardiovascular diseases, diabetes and hypertension, definitely calls for a product that takes care of the expenses for a lifetime.

“Lifestyle diseases have a long-term impact and its treatment is an ongoing process. Along with medical treatment, lifestyle modifications are also required. These products should take care of both the needs. On these lines, we can look at disease-specific policies for heart ailments and obesity,” added Sugathan.

Maternity cover: Coverage for pregnancy and other associated events is very important for female policyholders. However, in India, this is offered only on employee benefit plans or few other retail line products, which have a few years of waiting period. “Since it is a vary critical area where health insurance may extend cover, it is seriously being looked at by insurance companies. In almost all developed markets, like Europe and USA, maternity cover is available on the retail platform,” said Datta.

http://www.mydigitalfc.com/insurance/health-insurance-set-get-innovative-941