While we have been happy with growth of health insurance segment in the recent years, some of the negative points have started appearing. In the conferences recetly attended by me, I heard the following statements:1. Insured getting policies issued from 3 insurance companies. Went for hospitalization, managed 3 original sets of bills, reports, receipts, discharge summaries. Lodged claims with all the 3 companies.2. Hospital having 10 rooms had informed the different Insurance companies/TPA’s that 18 rooms are occupied or say 18 patients are being...
Monday, 9 November 2009
We understand most of the approvals are through for setting up of JV between SBI and IAG of Australia and in the coming months this company will become operational.In view of the recent good achievements of SBI Life it is foreseen the competition will increase in Non Life Insurance/General Insurance segment.Extensive coverage of the branches of SBI all over the country will be a good feature of this compa...
Tuesday, 22 September 2009
TPA’s (Third Party Administrators) to deduct TDS when releasing payment to HospitalsRecent news item indicates that this decision is now being implemented.We are not going into details of the same from taxation angle but we feel that the impact of this will be increase in rates by hospitals as they will find it a necessity to increase the rates with a view to handle the increased need for working capital.The normal inflation of health care in India is 15% per year-should we expect 18% during 2010. Let us wait and wat...
It is always a pleasure to read independent articles in publications like Fortune, where an unbiased article can be an eye opener for all of us.This article is worth reading – where a group comprising of doctors and lawyers handles the cases and fights with Health Insurance company's so that the genuine or inflated claims are made on insurance companies and are also passed.The team covered in the article manages the best of doctors and they are assisted by lawyers to appear in the courts so that the client gets paid at much higher level. Ofcourse...
Monday, 31 August 2009
Medical Cost Contrast (Source Various editions of Hindustan Times Aug 2009) Many a times we come across question of persons who access our website and want to know about costs associated with various treatments .It is interesting to find some cost contrasts in various editions of Hindustan Times.We have compiled these for your reference so that you can interpret it in the best possible manner.1- Treatment: Treatment for brain hemorrhage and face reconstructive surgeryHospital: Apollo HospitalCost: Rs.1,22,922 (Including stay in the hospital)ICU...
Thursday, 20 August 2009
A common question asked is how much health insurance coverage do I need?It is a very simple as well as a very difficult question.Simple -whatever you can affordDifficult-it should cover whatever treatment you may need during the validity of the policy.I have come across a news item in HT regarding Priya ,who has undrgone liver transplant in Ganga Ram Hospital in New Delhi.It cost her Rs 22 lakhs.This does not incude the travel costs which she might have incurred as she is resident of Mumbai and decided to get the surgery done in Ganga Ram Hospital.As...
Large number of insurance clients ask us from time to time about the financial health of different insurance companies : As none of the company is listed on the stock ecxchange therefote it was not possible for a common man to find out which company is financially strong or weak .The good time is coming as the Insurance regulator IRDA will make it mandatory for all insurers to disclose their financial statements to the public, even if they are not planning to get listed on stock exchanges. Disclosures will apply to both public and private insurers...
Insurance companies have come out with some clarifications and these are;(1) Cost of Tami flu is not covered as this is being given by the Government on free of cost basis.(2) Private hospitals can charge the patient for facilities like tests, beds and doctors fees. And this will be covered.(3) If admitted in a hospital and the tests are negative then nothing is payable. If positive then it is payable.(4) If it is a new policy then 30 days clause is applicable. Summary of all above mentioned points is that do not wait but get health insurance policy...
Friday, 31 July 2009
An application will be submitted to IRDA for approval to Magma HDI General Insurance Co Ltd for setting up a general insurance company which will handle health insurance also.Magma Fincorp, a Kolkata-based non-banking financial company, is the Indian partner while Germany’s HDI-Gerling International Holding AG.will be the foreign partner.We welcome this.This company will be the second insurance company from Eastern India. The new company, Magma HDI General Insurance Co Ltd, will apply to the Insurance Regulatory and Development Authority for obtaining...
Saturday, 18 July 2009
One of the proposal of IRDA panel, which evaluated the performance of third party administrators, is for setting up of Health Insurance Council. They feel that this is one of the most critical requirements in the industryIt is understood that Insurance Regulatory and Development Authority (Irda) is considering to accept this proposal and “Health Insurance Council" will be set up.The proposed council will also look to standardize procedures in the industry, and update and maintain standard documents and "standard masters". It could also help solve...
One of the proposal of IRDA panel, which evaluated the performance of third party administrators, is for setting up of Health Insurance Council. They feel that this is one of the most critical requirements in the industryIt is understood that Insurance Regulatory and Development Authority (Irda) is considering to accept this proposal and “Health Insurance Council" will be set up.The proposed council will also look to standardize procedures in the industry, and update and maintain standard documents and "standard masters". It could also help solve...
Wednesday, 15 July 2009
Some buyers have been thinking they are smart and by creating excessive competition among Insurance co’s, and Insurance intermediaries they can bring down the insurance premium for Group health policy. As insurance companies have started looking at their portfolio carefully, we can say most of them have started canceling heavy loss making policies. We welcome this as we want healthy insurance companies as large assets of this country are also insured with them. According to one newspaper report cancellation of group Mediclaim policy midway has...
Tuesday, 14 July 2009
In management schools vertical integration is taught and there are positive and negative points in having the same.The greatest point is economies.At the same timeunder corporate governance, privacy and ethics aspects we are supposed to behave differently.TPA's are facing rough weather as covered in my various blogs in the past.As predicted by me the third-party administrator business in insurance is going through a churn, with conflict-of-interest issues hastening stake sales. Bangalore-based TTK Healthcare Services, a third party administrator...
Sunday, 12 July 2009
Very intersting and thought provoking question has come before us and it is ;Should lodging of fraudulent insurance claims be made punishable ?I came across an interesting news item which has originated from U.K. and it may be an eye opener for many. This judgement also raises the question whether Insurance Company should take the case to such level where the client (even if he has lodged fraudulent insurance claim) is jailed.You will find the answer in the last 2 lines of the news item in which the statement of the insurance company is as follows;Andrew...
Friday, 10 July 2009
Yes it is going to be true that HEALTH INSURANCE premium will touch Rs 12000 crores during this year.Mr. Harish Rawat, Minister of state for labour and employment, informed Rajya Sabha that Rashtriya Swasthya Bima Yojana (RSBY) is being extended to all 600 lakhs BPL families in the country during the current financial year.Taking average family size of 5 members this means that by the end of March 2010 we will have 30 crores persons covered under this Yojna.Assuming premium size is Rs 750 per family this means premium collected by the insurance...
Monday, 6 July 2009
While presenting the budget in Lok Sabha ( Indian Parliament ) on July 6,2009 Mr. Pranab Mukherjee ,Finance Minister made the following statement"Rashtriya Swasthya Bima Yojana (RSBY) was operationalised last year. The initial response has been very good. More than 46 lakh BPL families in eighteen States and UTs have been issued biometric smart cards. This scheme empowers poor families by giving them freedom of choice for using health care services from an extensive list of hospitals including private hospitals. Government proposes to bring all...
Thursday, 2 July 2009
The committee headed by S. B. Mathur, Secretary-General of the Life Insurance Council, has recommended the formation of a common body comprising members from the TPA’s, life and non-life insurance companies and hospitals and representatives from consumer groups.This is a good suggestion as consumer representatives may get a say in claims settlement for Mediclaim policies .We are hopeful that IRDA will accept this recommendation made by the Third Party Administrator Committee.The proposed body is expected to simplify and speed up cashless claims...
Wednesday, 1 July 2009
HEALTH INSURERS PLAN DATABASE TO CHECK FRAUD CLAIMSIt is intersting to read in The Economic Times about Insurers Data Base to be set upAccording to this nes item health claim data of individuals/families will be compiled for being used by the Health Insurance companies.My viewpoint is that Health Insurance has been a bleeding portfolio for not because of individuals but because of group policies, which are being picked up by the Insurance Companies at low premiums for achieving the targets .These targets are set up for managers and branches at...
The Times of India has carried an intersting news regarding RTI( Right To Information Act )being used by Anant M Nandu.The news item covered is :The Right To Information Act has come to the help of thousands of Mediclaim policy holders who have been struggling to get refunds for the excess premium they have paid.The Central Information Commission (CIC), in a landmark order, has directed New India Assurance Company Ltd to make public the details of the total number of policy holders who are still to get a refund for the excess premium charged. The...
Thursday, 25 June 2009
Very common question which we have from those who access our website is''Why I should buy health insurance from you?" Our reply is given and I thought let me put it down for benefit of many of you.We handle products of all Insurance companies As a leading health insurance source, we are able to offer our customers:1- Broad Selection. Because we are an Insurance Brokerage Company and not a health insurance company/an insurance company, therefore we can offer products from multiple insurance companies....
Thursday, 4 June 2009
On the one hand we notice aggressive advertising campaign of ICICI Lombard and at the same time we find the following statement has been issued by Sanjay Datta, head of health insurance, ICICI Lombard General Insurance, at an interactive session in Kolkata.The statement is " Like most general insurance companies, ICICI Lombard would not be aggressive selling group health insurance policy due to high claim ratio"We feel Health Insurance is a specialized product and co's like BUPA,Munich Re(DKV),Swiss Re will ultimately become active players in...
Very soon we will have Max BUPA and Religare Swiss Re entering the health insurance sector in India. With their joining we will have 4 co's in this sector and the details are;Foreign Partners in Health Insurance Co's of India - June 2009Name Foreign Partner StatusStar Health ETA Ascon, Oman Operational, Revenue Rs.511.93 crores (2008-09)Apollo DKV DKV...
Friday, 8 May 2009
Reliance General Insurance Company Limited has increased minimum sum assured limit for Health Wise Silver Plan to Rs.3 lakhs. Even though in leaflets/ brochures Reliance Health Wise minimum sum assured limit for Silver Plan is Rs.1 lakh. But in May 2009 Reliance has stopped accepting proposals for less than Rs.3 lakhs. It means minimum sum assured under Reliance Health-Wise Silver Plan is now Rs.3 lakhs. We feel that this is a step in the right direction as insurance companies are under pressure to control costs. Cost of issuing a policy is estimated...
Customers to benefit from New Renewal Rules for Health Insurance Policies w.e.f June 1, 2009These rules as announced by IRDA are:1. An insurer can’t deny renewal on any ground other than fraud.2. The policy brochure will have to clearly state the terms and conditions of renewal3. It will have to mention the age till which renewal will be allowed.4. It will have to mention the circumstances under which and the extent to which premiums will change.5. Insurers will have to intimate the policy holder about any change in premiums three months in advance...
Sunday, 19 April 2009
Many emails /phone calls which are received by us ask us the cost of specific treatment so that the sum assured is taken for suitable amount. Today I met a person who has recently gone for knee transplant in New Delhi and the cost he has incurred is Rs.5.50 lakhs( 550,000).Costs are going up.It is better to go in for higher sum in the beginning rather than realizing at the time when you need the insurance that you are having underinsuran...
Saturday, 18 April 2009
Provisional Health Insurance figures for India for the year ending March 2009 are now available.At Rs. 6500 crores this shows an increase of 30%. I personally feel the figure should be higher because of the fact that various schemes implemented by the Government of India for below the poverty line persons were implemented during the year. We were talking of crores of persons being insured. If that was true then 5 crores persons would have added Rs 400 crores, may be the impact of cut throat competition has resulted in group health insurance policies...
Tuesday, 14 April 2009
Wednesday, 25 March 2009
Yes we are expecting good activity in Health Insurance .At present ther are only 2 operating stand alone Health Insurance company's in India (1)Apollo DKV Insurance Company Limited(2)Star health and Allied Insurance Company LimitedWe have been hearing that 1 more co is going through approval process and it is Max BUPA.Suddenly we find that 3 large names from USA have become interested in the growing Indian Market These are (1)United Health(2)Aetna(3)CignaIt is great news as we as a country offer huge market potential and large no of stand alone...
Saturday, 14 March 2009
Who gives better Insurance advice Insurance agent or Insurance brokerage firm.The survey of Economic Tiles has revealed that 85% customers are not satisfied with the advice given by insurance agents.It is from time to time I have come across questions from customers where they wish to have the answer to the following; why I should use insurance brokerage firm in comparison to use of insurance agent. We have always pointed out that use of Insurance...
Now it is possible to have Bank loan for hospitalization expenses.Over 80% of population of India does not have any kind of insurance. A person who does not have the money to pay for the hospital expenses had no option but to accept suffering out of the illness/critical illness, if he was unable to borrow money from his relatives or friends. Chances of getting loan from money lender in the village/town were remote as the money lender was not sure whether he will get back the money or not.Punjab National Bank, one of the PSU Bank has come out with...
Tuesday, 3 March 2009
CII (Confederation of Indian Industries) estimates Health Insurance premium will touch figure of US $ 7700 Million (Rs 40000 crores) by 2015.According to Dr. Pratap Reddy, Chairman CII National Health Care Council, Health Insurance premium has the potential to touch the figure of Rs 40000 crores by 2015. Last year the figure was Rs 5000 crores. This means that figure will go up by 8 times in 7 years. It is heartning to read such estimates.Question before all of us is whether Indian Insurance companies or TPA's (Third Party Administrator) are prepared...
Thursday, 5 February 2009
Senior Citizens get relief with Cholamandalam issuing overseas travel policy for 270 daysMany foreign embassies insist for health insurance policy at the time of grant of visa.They limit the visa duration same as the duration of the policy. Australia is one such country.It is good that even though all companies restrict the policy for senior citizens to 180 days ,there is at least one company ( Cholamandalam)which is issuing the policy for 270 days.Our compliments to them for doing so, parents who spend lot of money at go to spend long time with...
Wednesday, 4 February 2009
Indian Insurance Companies don’t need the insurance premium from NRI’sIndia as a country got $ 39 billion(during 2008) from NRI’s who are working abroad. We even have a separate Ministry to take care of NRI Affairs, which shows the importance our Finance Ministry gives to money being sent to India in the form of foreign exchange. We organize full fledged international conference every year. This year it was organized in Chennai recently.It is surprising to note that we do not need the insurance premium from the same NRI’s.Our underwriting norms...
Friday, 16 January 2009
We have come across some good statistics about the claims made by health insurance policy holders in India. These are;Data Sourced From : 28 Third Party Administrators operating in IndiaClaims Made by Females : 6,50,070Claim amount paid : Rs 1,359 croreAverage Claim size : Rs 20,903Average Claim for Cesarean Delivery : Rs 30,000 to Rs 35,000Average Claim for Normal delivery : Rs 20,000 to Rs 25,000Claims Made by males : 6,08,023Claim amount paid : Rs 1,150 CroreAverage Claim : Rs 18,922No of claims made by those in the age group 41-60 = 4,30,000Amount...
Thursday, 8 January 2009
After the introduction of Top up policy by Star Health and Allied Insurance Company Limited now we have top up and super top up medicare policy from United India Insurance Company Limited. The good thing is that even if you do not have any health insurance policy you can go for it. In the case of Star health and Allied Insurance Company Limited you must have sum assured of Rs 3 lakhs and above (either from Star health and Allied Insurance Company Limited or any other insurance co) and then only you can go for it.The premium rates are awaited and...
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