You May Soon Be Able To key Health Insurers

The penetration of medical insurance is extremely low in our country, at around 15%, including all types of insurance central government health scheme, employee state insurance, group health and individual health. There are concerted efforts initiated by the government as well as the Insurance Regulatory and Development Authority (Irda) to improve the reach of health insurance to all sections of society and safeguard the interest of policy holders.

One of the important initiatives of the regulator is the proposed portability of health insurance. This is to ensure that a customer continues to enjoy benefits under his health policy even if he wishes to change his insurance provider for genuine reasons.

In the current scenario, a customer is more or less wedged to an insurance company, given that if he chooses another insurer during renewal, his policy starts afresh with all the waiting periods commencing again. For the uninitiated, waiting period is the time frame during which some of the claims shall not be payable under the health policy. For most new health policies there is a waiting period of 30 days under which no claim can be made other than accidents. Besides, there is also a one or two years waiting period for diseases like cataract, hysterectomy etc. And for other diseases which may have been existing prior to taking the policy commonly known as pre-existing diseases, the waiting period is for four years.

In simple words, policyholders will no longer be compelled to renew their health policies with their existing insurance company for fear of the waiting period starting all over again. As and when Irda introduces the portable health product in the market, customers who opt for such products will have the freedom to shift insurers without worrying about losing their continuity benefits.

Senior citizens, in particular, will benefit since they will find it difficult to shift their insurer if they are unhappy with their present one, as other companies would be reluctant to offer them new policies.

The introduction of a portable health product would also prove beneficial to insurance companies. This could act as a powerful product to approach the new customer segment hitherto untapped. And with competition, insurance companies would be thriving to continuously improve their efficiency standards in terms of customer engagement and relationship to ensure that the customers do not move away from them citing service deficiency.

In the current market scenario, it is very difficult to make a price comparison between products with exactly the same features. For customers who are price sensitive, opting for a health product with a lower premium might actually harm them at a later stage when they realise that the product features and terms & conditions do not cover (fully or partially) some of the ailments /conditions for which they have actually purchased the health product in the first place.

Portable health product on the other hand would have exactly the same features and terms & conditions and therefore a person intending to buy a portable product has to just compare the price before opting for the insurance company of his choice.

Hospital corpse to clarify position on cashless medical insurance

The Association of Hospitals, which represents most private hospitals in the city, will on Wednesday simplify its stand on the issue of cashless medical insurance. Many insurance holders had been left in the pitch as public sector insurance companies had determined to limit cashless mediclaim policies to only those hospitals that characteristic in the favorite Provider Network list drawn up by them.
This covered only 81 hospitals in Mumbai.
The public sector companies had done this saying the hospitals were billing patients advanced if they came under mediclaim.
The companies want hospitals to stay to a set of standard rates for surgeries and medicines.
“Hospitals are being asked to conduct bypass surgeries for Rs 1.8 lakh, which is not likely in a city like Mumbai,” said General Vijay Krishna, chief executive officer (CEO) of Breach Candy Hospital, who is a member of the association.
“The insurance companies are also saying they will buy equipment and medicines straight and give to them hospitals,” he added.
“This is just not practical. If we need some equipment immediately, will we have to wait till it is sent to us.”
“The insurance companies should have held a discussion with us before making such decisions. We have not been given a consideration,” he added.

Stopping cashless medical insurance is break of agreement

It is unfortunate that even public-sector Insurance Companies have joined private-sector ones in their cold attitude towards their individual customers when large number of chief hospitals were de-listed by these public-sector Insurance companies for extending cashless reimbursement for availing medical facilities through mediclaim policies. It is a break of agreement when the facility was discontinued uninformed to policy-holders unexpectedly from 01.07.2010.

However Insurance companies for prospect can issue two types of mediclaim policies, with cashless policies valid at all hospitals as before, at some higher premium than normal policies without cashless ability during treatment. But any such system should be for new policies only. It is pointless to break the contract with policy-holders by midway termination of any earlier prevailing facility including cashless mediclaim at different hospitals.

Union government should combine all public-sector Insurance companies in one united company to save largely on advertisements and overheads.