If you are persistent you will win

If you are persistent you will win The health insurance claim of Sanjay (name changed) was rejected by the insurance company. Repeated attempts by the insured with insurance company at various levels were not successful. We as Insurance Brokerage Firm advised him to take up the matter with Insurance Ombudsman. The matter took some time as the office of Insurance Ombudsman is having large number of complaints or cases coming up every day. After processing...

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4 PSU General Insurance Companies to come out with IPO

New India, National, Oriental & United all the 4 PSU General Insurance Companies will be coming out with IPO. Even though some newspapers have written that this is because Government of India is facing financial deficit.Let us look at the positive aspects of this move of the government;1. IPO by these strong Insurance Companies will set a healthy record for listing of Insurance Companies in India. It means putting the insurance companies shares on right path i.e. growth 2 or 3 IPO's by Private companies at high premium and then going down on...

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List of Insurance Repositories selected for maintaining the Insurance data in de mat form.

Recently when the claim was lodged for health insurance with a general insurance company then the delay in clearing /payment of the claim was that they had called for original proposal form , which was submitted when the insured had purchased the policy for the firs time i.e. 3 years back . What can be the situation if insured had purchased the policy 15 years back ?We always advise the clients that they should keep all the old policies of health insurance in a file ,as it may be needed in future ,when the claim is lodged.May be Repositories...

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Yellow markings in the skin around the eyelids are a warning to you as well as insurer

Researchers in Denmark have come out with a study after compiling data of 13000 persons and that too over 30 years . According to this those who were having patches, known as xanthelasmata were more likely to have heart attack or even die with it within 10 years.These spots are deposits of Cholesterol which are soft and painless. They do not interfere with eyesight /vision. People generally go to dermatologists or skin specialists and get these treated.In this Danish study started in 1970’s 12745 people were in the control group Out of this...

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Apollo Munich / L & T / Max Bupa- which one is better and why?

Apollo Munich / L & T / Max Bupa- which one is better and why?These 3 private sector companies are competing for business from premium customers or HNI’s, (high net worth individuals) who are looking for better health insurance products with good and attractive features.Let us see the comparison ;L & T is charging premium 72% higher than premium of Apollo Munich or 25% higher than premium of Max Bupa. The additional benefits offered are:...

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Today (Oct 1, 2011) is a good day as portability of Health Insurance policy has started on Oct 1, 2011Our compliments to IRDA for bringing this change.In case any one of you faces any difficulty please inform us or comment on this blog so that it can be taken up with concerned authorities/Insurance Companies.We feel with a view to fulfill 45 days condition Insurance Companies should start issuing renewal notice 60 days in advance, because only then...

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HIV patients will be able to get health insurance policy issued

Under the present guidelines of various Insurance Companies have not been issuing Health Insurance policies to HIV patients. From time to time we had expressed that insurance policy should be issued to them, with HIV being mentioned as preexisting disease. We always felt that HIV patient can be involved in accident and may need hospitalization. He can also get some disease which has no correlation with HIV.It is good to know that IRDA has considered this viewpoint favorably and in near future Insurance companies will start issuing policies to HIV...

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It is depressing to know that bribe is demanded in a hospital

Reading of this news item (The Times of India) left me thinking -why it happens in India.But why it happens? There is urgent need to establish more and more medical colleges/hospitals wish that next budget will bring some proposal which will encourage setting up of medical colleges as will as hospita...

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Be ready to pay Service Tax on health care from next budget (2012)

Be ready to pay Service Tax on health care from next budget (2012). There are clear indications that government is going to impose Service Tax on health insurance from next budget (2012) In case of health care- two options are being considered. Option 1. To exclude all services provided by clinical establishments with turnover under Rs.4 crores from the tax. This means that apart from your medical bill at a large private hospital you will also have to pay service tax, which could be 10% of the total amount. The implication of this will be that...

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Give with one hand –take it away by other hand

Give with one hand –take it away by other hand.It is very common to hear this type of statement. The same thing was noticed in one of the news item according to which Apollo Munich is going to get approval for health insurance product for senior citizens of any age. This product is going to get approval of IRDA by end of August 2011.This is one part of the story where it is giving with one hand. The cooling off period will be 1 year or 12 months. This is what we have called is taking away by other hand. We feel Cooling off period of 12 months is...

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Rs 10000 crores underwriting loss by our non life insurance industry during 2010-11 –it needs attention of all of us

Rs 10000 crores underwriting loss by our non life insurance industry during 2010-11 –it needs attention of all of usIt is disappointing to know that Indian general insurance industry which touched premium figure of Rs 42000 crores during 2010-11 has incurred underwriting loss of Rs.10,000 crore .Does it give a signal that for next 5 years these companies will go on incurring losses.According to Mr. G Srinivasan, chairman and managing director, United India Insurance, commented that the challenges for both the industry and individual insurance...

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Free Medicare to all citizens- Time to introspect

Free Medicare to all citizens- Time to introspect.Times of India of Aug 8, 2011 has carried a news item on the concept being considered under free medicare. Part of it is:“Working towards its aim of providing free healthcare to all, the government is planning a national health entitlement card (NHEC) for every citizen that will guarantee access to a package of essential primary, secondary and tertiary healthcare fully funded by the centre.The proposal, finalized by a high-powered expert panel of the Planning Commission, talks of covering both in-patient...

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Let us include OPD in our health insurance policies.

Let us include OPD in our health insurance policies.OPD coverage is equally important. Are we living in mid-eighties when Mediclaim product was developed with coverage for Curative treatment?The News item as above shows the importance of Diagnostic tests where small amount would have saved pain and agony to Joshi/Mishra, their families and the claim which insurance company will have to pay. Imagine the productivity loss which the employer of Joshi/...

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Is it possible to reduce health care costs?

Is it possible to reduce health care costs?It is very easy to increase costs. The challenge comes when you have to answer question“Is it possible to reduce health care costs?”The truth is yes, it can be reduced if Tiger biscuits can be produced packed transported & then sold at retail level at Rs.50 per kgm by a reputed company Brittania- then why it is not possible to reduce costs when it comes to Health care.In health care economies can be...

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Consolidated document containing all terms and conditions on health insurance to be issued by Irda

There have been so many notications pertaining to health insurance that Irda may comeout with a conslidated document having all terms and conditions pertaining to all players( Insurance Companies,TPA,s,Intermediaries). This will help all players/customers to refer to one document and have all the queries answered.If this comes out -it will be a very good step. We welcome this propos...

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OPD coverage to make beginning in Indian Health Insurance

Non coverage of OPD has been one of the major weakness of Indian Health Insurance policies.As a part of RSBY pilot project is being launched in Puri ,Orissa and will be followed in Mehsana, Gujarat.We are sure this will result in reduction in claim figures in these pilot projects and scheme will extended to all over the country.What ever happens to RSBY is ultimtely going to spread to all the polici...

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TPA,s should provide service to Insurance Companies only

In the recent past we have been hearing that TPA,s have started providing services to corporate clients inmanaging their health care schemes.Irda does not wish this to happen.This is a good news.Insurance industry lost some of the corporate clients where the cliam ratio was much less than 100%.As a result clients wwhich were adding to the favourable margins were being lo...

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PSU's still retain 59% market share of Indian health insurance market (2010-11) of Rs.11145 crores

The health insurance figures for the year 2010-11 are available and PSU's have achieved premium figure of Rs.6578.64 crores vs Rs.4949.67 crores(2009-10). This is 59.02% market share vs 59.09% market share which was achieved during last year. Health Insurance Premium of Indian Insurance Companies 2010-11 vs 2009-2010You will notice that every company has shown growth in business with exception of Chola.Growth during the year of this portfolio is...

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Some are going & some are coming

Bharti group has sold Bharti AXA (both life & non Life) to RIL (Mukesh Ambani Group). DLF Pramerica is being sold to HCL (Shiv Nadar Group). Future Generali (Kishore Biyani Group) is looking for buyers for both of its Insurance companies. After tasting the attraction of Insurance sector many well known names /business houses have decided to leave.At the same time some are getting in this sector .Mahindra & Mahindra is entering non life business. . Magna is also entering non life. Edelweiss is entering Life business.Religare Health should...

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CORIS Gipsa TPA JV is not coming

There were indications that CORIS Gipsa TPA JV will become operational by end of 2011 and as a result of the same New/National/Oriental/United (4 PSU’s) will shift their TPA work to the new company.Tenders were floated and Coris, a French company was selected. Suddenly we find that JV is being dropped. Tendering/Selection process has come under cloud and it was decided by the high ups to avoid negative publicity by dropping this JV.May be it is the end of the JV idea. Let us wait & wat...

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Emphasis is needed on preventive cure

Emphasis is needed on preventive cure.More and more emphasis needs to be put on preventive cure to reduce hospitalization claims. We always thought that good hygiene is important for healthy life but correlation of brushing teeth twice leading to lower cardiac illness risk is a good and interesting study. This has appeared as a news item in T...

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Health Insurance portability is delayed

Health Insurance portability is delayed.In one of my blog I had written that portability of health insurance is having complexities and it will take much longer time to become effective. We have been advising clients that do not postpone buying of Health Insurance policy for portability conditions to be known and being effective. This has happened as the portability is delayed from July 1, 2011 to Oct 1, 20...

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Frauds have no limit in insurance claims

Frauds have no limit in insurance claims.The following news item is an eye opener, where the person concerned tried to have a claim by taking his father’s death and even managing documents required for lodging claim.The question before us is:Was the claim lodged with American Insurance Company, who asked the investigator to investigate the case?Is it that Indians have stared buying life insurance from foreign insurance companies in foreign?We have...

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It makes sense to pay 2 years premium and save good amount of your money

It is from time to time people used to ask whether they can pay 2 years premium .Many dropped the idea after knowing the savings,which ws not much.Apollo Munich has come out with a good option under which you can save 7.5% by paying 2 years premium insted of 1 year.If you look at it carefully you will realise that as far as2 nd year is conecerned the saving turns out to be 15% as far as second year is concerned as this year premium you had to pay even otherwi...

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Are the financial results of our General Insurance Companies disappointing?

Yes, it is disappointing to see that large numbers of General Insurance Companies are incurring losses and heavy losses.Loss figure leaves impression that claims settlement will be a delayed process and may be you will have to settle with figure of 60% or 70%.Of claim lodged. This is because of the fact that it is important for insurance companies to pay salaries/ bills/travel expenses and then only they can think of funds availability for payment...

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Healthy long life is good- Are you prepared?

We are living longer and in few years the average age of Indian citizens will touch 75 years or may be 80 years. Are we prepared to live longer but in a healthy way? Have we planned for our health care in the coming years? Very few persons have planned for health care, the fact is that for many age related treatments like hernia, cataract, hysterectomy, knee replacement a person may have to be hospitalized.What I find is that majority of people have...

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Why you should buy Health Insurance?

1. Good health is most important thing in your life. When you need health care treatment then you must have it, otherwise the whole world seems to be worth nothing to you.2. Health care costs are increasing due to• Normal inflation due to increase in petrol costs, electricity costs, taxation, imposition of new levies/taxes.• Improvement in medical technology results in availability of new equipment, which is better, more accurate in diagnosis. We...

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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%: 4...

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Indian Health Insurance Market- 2010-11

Indian Health Insurance Market- 2010-11Estimates 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...

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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 coverageSuccessful 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...

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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...

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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...

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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 complimen...

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Budget 2011- Impact on Insurance/ Health Insurance

Budget 2011- Impact on Insurance/Health InsuranceLast day of February and people listen to the speech of Finance Minister of India, watch the analysis on TV and read comments in newspaper.What does it mean to us with respect to Insurance/ Health Insurance 1. All unit linked insurance plans will attract Service Tax so depending upon company/ charges you will definitely pay more. For example, if you paid an annual premium of Rs. 10,000, the service tax (of 10 per cent) charged was Rs. 100. Now, the tax to be paid will be Rs. 150. These charges will...

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Health Insurance portability from July ,2011 - Will it bring significant difference to Indian consumers

The significant point which you as a consumer can expect from the portability of health insurance policy (change over from existing insurance company to another insurance company )coming from July 1 ,2011 will be that even if you have an existing disease ( for which you have been treated /paid claim by existing insurance company in last few years say 2 years)you will be able to switch over to another insurance company .You will not be asked to wait for period of 4 years ( pre existing disease being mentioned in the policy as a result of which...

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The Emperor of Maladies:A Biography of Cancer

The Emperor of Maladies:A Biography of CancerIt is nice to know about achievements of some of our youngsters, who went to USA studied, worked, progressed and have brought fame to India.Dr Siddhartha Mukherjee, author of ‘The Emperor of Maladies: A Biography of Cancer’ is one such person.He has came out with a 6 point formula to help India control and combat the cancer epidemic and these are:1.Put in place a strong tobacco control programme2.Initiate sexual health education to prevent sexually transmitted cancers like cervical and oral3.Encourage...

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Health Cover for all Indians will change the scene

In one of my blog I had suggested that all senior citizens should be asked compulsorily to go in for health insurance.On the same concept Indian Government is considering to cover all citizens with Health Cover during Five year Plan (2012-2017).Let us see what it means to you, me or all of us. Different studies may come out with different statistics .If we make some assumptions;India population: 120 crores Family size: 5Households: 24 croresWith...

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Let us welcome Religare ,which is coming up with Health Insurance company

For quite sometime we have been reading news that Religare is looking for foreign partner for launching Health Insurance Company .Some of the approvals have been granted to joint venture with Union Bank Of India.Let us welcome the entry of 1 more 100% stand alone health insurance compa...

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