Gross Premium Underwritten by General Insurance Companies during 2010-11

Estimates/statistics of premium earned by General Insurance Companies for the year ending March 2011 are available and the overall increase during the year has been 22%.

Four Public sector companies have crossed the figure of Rs.25001 Crores which needs appreciation by all of us. Total premium of all the Pvt Sector companies (2010-11) is Rs.17567 Crores. Public sector vs. put sector share is 59%: 41%.

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Indian Health Insurance Market- 2010-11

Indian Health Insurance Market- 2010-11

Estimates of Indian Health Insurance Market for the year ending March 31, 2011 are now available and according to it this market has touched figure of Rs. 11000 Crores.

Group Corporate portfolio and Group Government portfolio (Schemes like RSBY,) continue to be a loss making portfolio. Retail portfolio continues to be the group where insurance companies have been successful in reducing the claims figures by following rigid norms. May be the decision of PSU’s to go in for strictness i.e. July 1, 2010 and strengthening of PPN has resulted in good results.

Let us hope that all segments of health insurance portfolio will be profitable in few years.

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Health care is achieving new heights in India; let us bring innovative changes in Health Insurance coverage

Health care is achieving new heights in India; let us bring innovative changes in Health Insurance coverage

Successful knee replacement of 93 years patient by team healed by Dr. Raju Vaishya of Apollo Hospital New Delhi needs appreciation. The person who was bed redden for 1 year will be able to walk. What a great feeling of achievement for our health care industry .At the same time let us not forget that most of our health insurance policies come to an end at the age of 75 or 80 years.

According to Dr Raju Vaishya “In India longevity of people is increasing and we now have more people living beyond 70 and soon there will be those who will live beyond 80 years.”

The wish of the clients is that all insurance companies should make health insurance policies renewable till the life of the insured. Some have started doing this .Let us hope that during 2011 all the insurance companies will modify there products.

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Are they supporting each other Or are they fighting with each other?

Recently we came across a news item that 64% of the cases which came up before Insurance Ombudsman (located all over the India) was pertaining to health insurance portfolio. Let us look at the facts;

Health Insurance as % of non life insurance portfolio = 32%
Group policies issued under Health Insurance portfolio = 50%
Policies issued to Individual/ Families = 50%

It means policies being issued to Individuals/ Families are only 16% of total non life insurance portfolio.

General impression is that claims arising from group policy get paid because they have the bargaining /negotiating power .It means that Individuals/ Families are the worst sufferers as this is the group which is having claims being disallowed.

The question before us is how many of the dissatisfied customers are able to reach the office of Insurance Ombudsman?

64% figure is really a very high figure .Let us try to look at the reasons for this scenario or why it is so?

There are 3 players.

Role of every player is to provide good service to the customer. When the insured has to go in for hospitalization then each one ( Insurance Company /TPA/Health care Provider ) is trying to pass on the buck to other player as if the objective or job description of each one is who can harass the customer most so that he runs away and forgets about claim .
Health care provider says that this insurance company is blacklisted or this TPA is black listed

TPA says that this health care provider is black listed.

Insurance Company says that they are ready to consider the payment of the claim but it will not be on cashless but on reimbursement basis. This defeats the basic assumption of the client that when the need arises he will be able to have payment coming from insurance company.

We need the change in thinking at all levels.

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Is liposuction for obesity – Is it only cosmetic surgery or Is it the need of the day?

Is liposuction for obesity – Is it only cosmetic surgery or Is it the need of the day?

Liposuction is a surgery technique which can be used effectively as a treatment for obesity. Is it right to treat it under the head of Cosmetic Surgery and not allow the expenses for claim under health insurance policy. This has been the practice of all insurance companies.

According to Dr. Satish Arolkar, Plastic Surgeon and senior Consultant at the Asian Heart Research Center in Mumbai “There are many who feel that some of the cosmetic procedures should be allowed an insurance cover. Treatments such as liposuction and abdominoplasty should be covered under insurance as they target obesity.”

We know obesity leads to Complication like diabetes, heart aliments, knee replacement and the claims come in the range of Rs 2 to 5 lakhs. Is it that insurance companies are taking a short sighted approach by not allowing liposuction and abdominoplasty?

The earlier we take far sighted view and enlarge the range of our health insurance polices the better it will be.

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Yes public opinion can compell even the Finance Minister of India to withdraw service tax

Compliments to Dr. Devi Shetty for taking a bold step in leading the campaign to withdraw the service tax.

All of you , who took up the matter in electronic and print media for withdrawl of this tax also deserve compliments.

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