Oriental to come out with policy for senior citizens

National was the first one to come out with policy for senior citizens.It was followed by New India and United .Star is the co from Private sector ,which has been offering this policy.

Now it is the turn of Oriental to introduce the policy.Salient points of the policy will be ;
Entry age 60 yrs
Max age upto which the policy will be available will be 85 yrs
Max sum assured possible is Rs 2 lakhs only.( Rs 1.5 lakh for New India,RS 3 lakh for United,Rs 1 lakh for National)
Premium for age group of 60 to 65 for Rs 1 lakh will be Rs 3850 +Service Tax.This is lower than the premium being charged by National or Star.Good show-we welcome this.
Pre existing disease will be covered after 2 /3 yrs.

IRDA approval is awaited and then the formal announcement will be coming.

Oriental to come out with policy for senior citizens

National was the first one to come out with policy for senior citizens.It was folloed by New India and United .

Oriental to come out with policy for senior citizens

National was the first one to come out with policy for senior citizens.It was folloed by New India and United

Health Insurance gets attention of Chambers of Commerce

Few weeks back we had a conference in Mumbai,which was organized by CII.Now it is the turn of FICCI . This proves my prediction of 2005 (as mentioned in the first edition of the book Best Guide to Buy Health Insurance ) that Health Insurance will be one of the highest growth segment of Indian Insurance Industry.

FICCI is organizing a one-day conference on "Sustainable Health Insurance - Need of the Hour" on 29th November, 2007 at Federation House, New Delhi.

You will have the opportunity to hear the viewpoint of Mr C S Rao Chairman,IRDA as well as many other speakers ,who matter in Indian Health Insurance Industry

Those interested in attending this conference can contact Ms Natasha Wig/ Ms Neerja Dhamija at Ph: 011 - 23765339, 23357391; Fax: 011 - 23320714, 23721504; Email: finance@ficci.com.
Entry fee is Rs 3500.

Should we have standard format for proposal form for all insurance co's

Different insurance co's use different formats for the proposal.Many a times the branches are out of stock of printed forms.While we welcome the independence of all the co's but a standardised form will be a cost effective way to handle the whole thing.It will be easy to follow in this large country.If most of the co's can handle health proposal in 2 pages format then why someone should be using 4 page format.If the survey /study reveals that 4 page format is the right thing then let all of them follow 4 page format.

Hats off to Reliance General ,which has done away with these forms and issues the policy by giving a receipt ( half of A4 size paper) along with policy on the spot.

Comments are invited.

Is it becoming more difficult to insure a small group of say 25

Yes,it is becoming difficult to insure a group of say 25 persons.Most of the co's want that client should take individual policy for every one.Is it that Insurance co's want to increase the number of policies issued by them.In the case of 25 persons they will be able to issue 25 policies.

India like any other country survives on small enterprises.A medium size store employing 25 persons wishes to have the policy so that it can retain its employees being attracted towards joining large stores.

We sincerely hope that atleast specialised Health Insurance co's ;
Star
Apollo DKV
will come out with policy specifically oriented towards sme's.It should cater to group size of 25 to 75.

They can consider developing a specialised product to be sold only through Insurance Brokers Channel.

Broader definition of Pre existing disease-its impact

Some court judgements on pre existing disease,view point of IRDA & General Insurance Council is that definition of Pre existing disease should be made very clear so that Insurance co's do not use it as an excuse to repudiate the claim. This is a welcome step in the interest of the consumers located all over the country.
If it results in broader interpretation then claims ratio will definitely go up.We forsee the impact will result in increase in premium rates in the years to follow.
Let us see what happens.

Oriental Insurance asked to pay Rs. 1.5 lakh by Consumer Forum Court

Simran Kaur was born with a boil at the time of birth and after several years was advised to undergo surgery at the base of the spine. The Insurance Company rejected the claim by declaring it as a preexisting disease.

Justice Kapoor said “day to day problems of pain, swelling or fever can not be termed as preexisting disease., thus any attempt on the part of the insurer to repudiate the claim for such non disclosure is not permissible.’

We appreciate the judiciary system of India, which is protecting the interests of the consumers.

Health Insurance Claims being rejected under preexisting disease clause

Rejecting the claim in the first instance by declaring it as a preexisting disease is a very common excuse. This is turning out to be a common complaint of more and more insured persons, whom I meet. It is only on persuasion of the insured with Insurance co or its TPA that most of the cases are reconsidered and processed. The common grievance of the insured clients is that they are told this in oral only and not in writing.

It is natural that those whose cases are not considered a good number of them either end up in Consumer Forum courts or become negative publicity in the society and discourage others from buying health insurance.

In a recent judgment New India Assurance has been directed to pay Rs. 2.29 lakhs+interest @ 9% from February 1, 1999.In this case client was paid Rs. 88,000 under 1 claim and after 5 years a case was filed again. The Insurance company repudiated the claim as it was preexisting disease.

With this judgment it is clear that if the policy is continuing then as and when the insured goes again for hospitalization (with the same illness/disease)then the claim is payable.

We appreciate the judiciary system of India, which is protecting the interests of the consumers.

Is 1 year health policy cumbersome?

In UK health policy is sold with long term perspective but in India we sell it with 1 year perspective.Our present system is more on US pattern.

For having peace of mind the customers will be happier with 10 years plan but with fixed rates known to them.This is similar to fixed interest rate vs floating interest rate.

Recent increase in rates by New India/United -for higher age group going up by 80% or so has really shaken the confidence of the insured .

Apollo DKV also on OPD/co pay bandwagon

Apollo DKV is planning different insurance products for the urban, rural and corporate populations. For the urban population, they are developing products to include all — doctor’s consultation, co-pay, outpatient visits and post-illness coverage. In the corporate segment, the products will include preventive health coverage, customised for corporate groups.

Products are under development.We feel for OPD the methodoly will be that if 25% is co pay amount ( to be paid by insured ) then he should pay that much amount at the time of consultation .This will result in no claim forms to be filled up at later date as balance amount will be paid by insurance company to the doctor or hospital.

Send request to Finance Minister to abolish Service Tax on Health Insurance policy

Budget is under preparation in the Finance Ministry in New Delhi.General Insurance Council has sent a proposal to Government that service tax should be abolished on health insurance policy.

Let us put pressure on the Government by sending request in this regard.You can write/print the letter addressed to ;

The Finance Minister
Government of India
North Block
New Delhi 110001

Send it to me at following address;
Mr S K Sethi
449 Kailash Tower 2
East of Kailah
New Delhi 110065

We will collect all the letters and will submit it to The Finance Ministry.Our target is 10000 letters.Yours is one of them.

Health Insurance Premium is now 0n 3 rd position

It was predicted by me in 2005 at the time of release of book Best Guide to Buy Health Insurance that Health insurance business will grow at a faster pace in the years to come.

During year ending March 2007 health insurance premium has moved from 5 th position to 3 rd position.Ofcourse first postion is with Motor Insurance.

In the year ending march 2009 Health will definitely move to 2 nd position.

Let us hope for more and more products and better service from Insurance companies

LIC will start policy with Health risk coverage

LIC is expected to introduce its haelth insurance product during Nov. 2007 . It will be a product where part of the premium will go towards savings and part will go towards risk coverage for health coverage.

Claims settlement will be through 8 TPA's on all India basis.However payment will be made through 3 banks;
Axis Bank
Bank of America
Syndicate Bank

While we are awaiting for the details of the product,yet to be announced-we are of the opinion that
+points of the same are;
1.Product will be available through large network of agents of LIC
2.Product with term of 10 years will result in issue of renewal noticeon yeraly basis.We are assuming 1 month grace period for payment of premium will be available.
3.Product may permit quarterly /half yearly/yearly payment

- points are;
1.If a customer can buy policy from a non life co for Rs 1400(say sum assured of Rs 1 lakh)then premium to be paid to LIC will be some thing like Rs 1400+saving element,which means something like Rs 3000 or so .May be Rs 5000.

Details are awaited from LIC and we will cover this in the coming days/weeks.

Will Health Insurance Policy holders get treated in Medicity

Ambitious Medicity Project of Dr Naresh Trehan (Escorts Heart Centre fame)is taking shape in Gurgaon.Dr Trehan plans to use the combination of Allopathy, Ayurveda, Homeopathy and Chinese Medicine to treat the patients.
As health insurance policies of most of the Insurance companies in India cover Allopathy treatment only and do not cover the other 3 systems of treatment,therefore we feel patients wishing to undergo treatment through alternative systems will be put to lot of inconvenience.

Cashless payment will become a cause for irritation and frustration as it will be difficult to quantify what % of the package cost can be attributed to Ayurveda form of treatment.
This is the right time that insurance companies should include Ayurveda, Homeopathy,Chinese System,Naturopathy, in the inclusion list and introduce new products.
This photo is taken from Business Standard dated Oct 2,2007

Health Insurance Premium of various Indian co's 2007

Every one is curious to know which Insurance co is biggest or which one is growing at a faster pace in Health Insurance segment.IRDA has released the figures and these are as above.Public Sector growth is slowing down while Reliance has shown growth of 686% because of aggresive pricing which they introduced in Dec,2006.

Health Insurance Pemium of various co's in India

Every one is curious to know who is big in Health insurance or who is growing at a faster pace in this segemnt.Figures for 2006 -07 are available and these are as follows;

Health Insurance for Unorganised Sector

On 15 th August Prime Minister had announced that a scheme costing Rs2000 crores will be announced for Health Insurance for people below the poverty line.

On 1 st October Finance Minister has announced the scheme.The salient points of the same are;

Name is Rashtriya Swastha Bima Yojana (RSBY)
No of families to be covered 1.2 crores
Family covers self,spouse,3 children
Beginning April1,2008
Sum assured for the family Rs 30000
Smart cards to be used.Valid all over the country.Benefits migratory labour.
All existing diseases to be covered.
Exclusions may be AIDS/HIV,STD's,drug and alcohol induced illness,congenital external diseases,sterilisation and fertility related procedures
Central Govt will bear 75% cost .State Govt will bear 25%
Till date 18 states have agreed to implement this scheme.
North Eastern States are ready to bear 10% cost only.
All PSU's and Private sector co's will get the opportunity.
State Govt will identify hospitals,Insurnace co,people eligible under BPL,who are to be issued smart cards

It is a welcome step when India is celebrating 60 years of indepenence.

During 2006 -07 Health Insurance premium was Rs 3210 crores .We forsee this figure will increase to Rs 5600 crores during 2007-08 .It will further increase to Rs 8400 crores during 2008-09.To this we will have to add Rs 751 crores being allocated by the Govt for this scheme so we can expect figure of Rs 9150 crores .

Comments are invited.

We are pleased that role has been given to private co's and state goverenments to implement this scheme.This issue was covered in one of our blog.