New India starts sale in health insurance by offering 5% to 10% discount

Various Insurance companies increased the premium by following each other.There has been heartburn and criticism in blogs,press & electronic media.Even IRDA had to issue the instructions in this regard.

It is nice to know that New India has announced the following discount structure for those going in for renewal of the policy without making any claim in the current year.

Mumbai 10%
Delhi/Bangalore 7.5%
Rest of India 5%

We feel there is scope in management of the hospital expenses,negotiating for rates for surgeries,going in for special rates for the rooms/icu's. Let GIC(General Insurance Council) play a leading role in bringing down the hospital expenses and pass on the benefit to clients/customers.

Let IIM or ISB be given the assignment to undertake the study /research paper on the profitability of the hospitals/ loss of Insurance co's so that corrective steps can be initiated.

New India starts sale in health insurance by offering 5% to 10%discount

IRDA ASKS PSUS NOT TO FORCE ELDERS TO SWITCH TO NEW HEALTH PLANS Mumbai, March 17, 2008The Economic Times (Delhi edition) The Times of India (Delhi edition)
Insurance regulator Insurance Regulatory and Development Authority (IRDA) has asked state-owned insurance companies not to force senior citizens to switch to a new health insurance plan with lower benefits at the time of renewal of policies. The regulator has reiterated that insurers cannot raise rates on mediclaim policies by more than 50-75% of the previous year’s premium, following an adverse claims experience. With complaints pouring in from senior citizens, the regulator has set up a special cell to look into their complaints. The regulator has appointed R Srinivasan as officer on special duty, in charge of the cell based at IRDA’s Hyderabad office. Senior citizens who have problems with their mediclaim renewal can contact this special cell. The IRDA panel on health insurance issues faced by senior citizens mooted the idea. Senior citizens’ association has been clamouring for a special cell, given that health insurance accounts for over 15% of non-life premium. The IRDA panel had also recommended a health insurance pool under the aegis of IRDA to take over high risks cases, including the ones whose renewal premium is hiked by over 40%. A similar pool exists for motor third-party liability insurance. IRDA is yet to take a view on the pool for rejected health insurance covers. Incidentally, the regulator had put a similar cap on rates for third-party liability insurance a couple of years ago, even after it was decided to increase rates by over 100%. In a circular to public sector insurance companies, the regulator said that PSUs have already revised the premium rates in respect of mediclaim policies in April 2007. “The authority received several complaints from senior citizens that renewal premiums charged to them were exorbitant. The authority, therefore, advised all the public sector general insurance companies that: The loading of premiums if justified for renewals of mediclaim policies issued to senior citizens shall not exceed 50-75% of the premiums charged prior to the revision.” IRDA has also said, “Senior citizens shall not be compelled by the insurance companies to migrate to other health insurance products, if it is to the disadvantage of senior citizens. The above instructions are applicable to renewal cases only. The authority has now created a separate cell to attend to the grievances of senior citizens in respect of non-renewals or exorbitant increases in premium of mediclaim policies of public sector general insurance companies,” the circular said.

IRDA tells Insurance co's to not to overcharge elders for health insurance

The Business Standard has covered an interesting news item regarding over charging of senior citizens for Health Insurance by the Insurance companies.
We find the heading of the newsitem
''Don’t overcharge senior citizens, Irda tells insurers '' very bold and interesting.
The insurance Regulatory and Development Authority (Irda) has warned all public sector general insurance companies to not to charge higher premium from senior citizens on medical insurance policies or mediclaim. According to industry sources, a leading public sector general insurance company is charging senior citizens almost Rs 1,000 extra in premium. For example, for a sum assured of Rs 1 lakh, the company is charging Rs 2,700 in premium compared to Rs 1,500 before the revision. It may be recalled that all public sector general insurance companies had revised mediclaim premium n April 2007.
Irda further added. “The Authority has received several complaints from senior citizens that renewal premiums are exorbitant. Senior citizens should not be compelled by insurance companies to migrate to other health insurance products if it is to the disadvantage of senior citizens.”
The regulator has asked all chairmen of public sector insurance companies not to exceed 50 – 75 percent of premium charged prior to the revision. Meanwhile, the regulator has created a separate cell to attend to grievances of senior citizens in respect of non-renewals or exorbitant increases in premium payments on mediclaim policies by public sector general insurance companies.

Those of you who want to send complaints can send these to ;

The Grievances Cell
Senior Citizens Health Insurance
IRDA
3 rd Floor
Parishrama Bhavan
Basheer Bagh
Hyderabad – 500004
Attn. Shri R Srinivasan,Officer on Special Duty

Incidentally people are curious to know how many policies have been issued to senior citizens?

An effort by Mint to get this info resulted in total silence from all insurance co's and no one revealed any figure.

We estimate it is less than 2000 on all india basis.

Delhi Govt to start HEALTH INSURANCE SWASTHYA BIMA YOJNA

According to The Tribune
The Delhi Cabinet has also decided to launch “Rashtriya Swasthya Bima Yojna” (RSBY) next month. The decision was taken today in a cabinet meeting presided over by Chief Minister Sheila Dikshit. While briefing media after the meeting, Dikshit stated that the RSBY would soon be launched in Delhi with an aim to provide health cover to around 4.40 lakh workers who have been issued BPL ration cards in Delhi. Most of these persons have been working in the unorganised sectors. It is meant for providing quality health cover to the workers and their families who possess BPL ration cards. She added that the RSBY would be launched next month in a function. The scheme would be implemented in association with Oriental Insurance Company Limited which would bear the cost of medical treatment up to Rs 30,000 a year per family. The beneficiaries of the scheme would be issued a smart card that will permit cashless medical transaction. The cost of issuing of the smart card would also not be charged from the beneficiary. Every person seeking insurance cover would have to get registered.

We welcome the step of Delhi Govt.

Are IRDA panel’s recommendations for securing health cover for senior citizens being swept under the carpet?

The Economic Times has covered a news item giving impression that
IRDA panel’s recommendations for securing health cover for senior citizens being swept under the carpet? The report was submitted almost three months ago and senior citizens want it to be implemented. But the Budget has remained silent on the recommendations while IRDA has merely forwarded the report to the General Insurance Council.
To make things worse for elders, insurance companies are now denying that there is any order from the regulator to cap mediclaim rate hikes at 75 percent.

Health Insurance Products from Max New York Life

All news papers have carried the news item that Max has entered health insurance field.
It has announced the launch of Lifeline series of insurance policies bringing long term insurance coverage for hospitalisation, surgeries and critical illness. According to Managing Director and Chief Executive Officer of Max New York Life Insurance, Gary Bennet, the policies have some significant “firsts” to its credit. Director, Marketing (Product Management and Corporate Affairs), Debashis Sarkar, said the policies come with fixed premiums for a five-year period, no claim discount on revised premiums, coverage for the largest range of ailments, free second opinion from the best in the country on diagnosis of illness and free telephonic medical helpline. The plan not only provided protection against medical expenses related to hospitalisation but also provided recuperation benefits.

It is nice to know that all PVt Life co's are finding this as a good market.
The qestion is are they followers - Do they treat LIC as their leader/

Buy TVS Auto rickshaw and get Health Insurance cover

The Hindu Business Line has carried the news item that those who will buy TVS auto rickshaw will get health insurance policy for sum assured of Rs 30,000
TVS Motor Company (TVSM) has formally launched its debutante autorickshaw TVS King, in LPG and petrol versions, marking its foray into the three-wheeler market. During the launch TVSM has also announced several welfare schemes for the autorickshaw drivers and their families, including a one-year free accident and healthcare policy. TVSM has tied up with few insurance companies for this and the policy would cover the owner and his family against medical care for up to Rs 30,000 per annum on a floater basis. The owner will additionally be covered by a personal accident policy for Rs 1 lakh.

We welcome this initiative of TVS .

ESIC is also covered under Consumers Protection Act

The first question arise after reading this news item is tht ESIC use the word Insurance then why it is not covered under IRDA.
DNA has covered a news item according to which
''Consumer courts have been given additional role by the government and the judiciary under the Consumer Protection Act (CPA), 1986. In a recent order of the Supreme Court of India, Employees State Insurance hospitals have also been included in the ambit of justice given by Consumer Courts. This was the order in the case of Kishore Lal vs chairman, Employees State Insurance Corporation (ESIC). Lal, a workman covered under ESIC, took his wife to an ESIC hospital for complications arising out of diabetes. She was admitted in hospital, but her condition deteriorated prompting Lal to transfer her to a private hospital. There it was known that both the diagnosis and treatment given to her was incorrect. Lal took his grievance to the district forum at Sonepat alleging deficiency of service. The forum held that the services rendered by the ESIC were gratuitous in nature and hence not covered under CPA and dismissed the case.

Kerala health insurance will cover those who are above the poverty line

The Hindu Business Line has carried news that Kerala will be the state which will offer health insurance even to those who are above the poverty line.
Is this that we have started diluting the scheme which has been developed by the Government of India for those who are coming under BPL.


The General Insurance Officers All India Association (GIOAIA), Kerala unit, has appealed to the government to implement the comprehensive health insurance scheme through one of the public sector general insurance companies only. Hailing the Kerala Budget proposal to introduce the scheme, which is based on the health insurance programme of the Union Government for below poverty line (BPL) families, P.P. Mohanan, Kerala State General Secretary of the association, said that the public sector general insurance companies had vast experience of 36 years in the field. Kerala scheme is open to persons outside the BPL category also, he said.

Let us have open field where PVt and PSU should compete.
Your comments are invited.

KOTAK LIFE IS ALSO ENTERING HEALTH INSURANCE

Kotak Mahindra Old Mutual Life Insurance Ltd, has also decided to launch a standalone health insurance scheme in the first half of the next fiscal. Till now, Kotak has been offering health schemes only as riders to its life insurance policies and this new scheme would be a standalone one, according to Arun Patil, company's senior vice- president for training and management. "This standalone scheme would cover as many diseases and eventualities as possible," he told reporters. Kotak would begin negotiations with hospitals for this scheme after this fiscal, he said, but declined to divulge further details. Let us see what can be the new benefits under the product of Kotak.

Will the floater health policies miss the tax benefits

The Economic Times has carried a news item according to which tax benefits may not be vaialble to those who are having family floater health policies.

According to Debjoy Sengupta
''Do you hold a floater mediclaim policy that covers you, your spouse, your kids and your parents? Well contrary to belief, you may not be able to claim the new benefit under Section 80D of the income tax that lets individuals covering parents to avail of an additional tax benefit — Rs 20,000 for parents who are senior citizens and Rs 15,000 for parents below 60 years. The FM in Budget 2008-09 has proposed an extra cut of Rs 15,000 under Section 80D to an individual who pays medical insurance premium for his/her parent or parents. What’s more, the fine print indicates if the parent happens to be a senior citizen, the tax sop is generous at Rs 20,000. But this may not apply in case of floater policies’ holders. For instance, insurers claim they “are not in a position to specify premium, which one pays for parents as the total sum assured is never separately defined.” “There is only an upper limit for reimbursement, which is the sum assured. This is where the grey area is!” said a source. A floater policy offers a certain sum assured for the entire family, a portion of which or the entire sum assured may be used by any one family member, including parents. Or may be shared by more than one. The insurer will pay at most the total sum assured for the entire family in a year, regardless of the number of members falling ill. “If an individual pays more than Rs 15,000 for a floater policy, the balance premium or even a portion of the remaining amount will not qualify for the new exemption for parents under Section 80D although he has covered the parents under the policy. This may act as a deterrent for buying floater policies for entire families and instead buy separate policies for parents. Premiums for floater policies are less than individual policies and offer flexibility when it comes to hospital bill reimbursements,” said an analyst.

We in www. healthisuranceindia.org feel that the Finance Ministry ,IRDA,Insurance companies shoul have an approach to simplify the procedures so that overheads are reduced and benfit goes to masses.
Options are;
1. There should be sum of Rs 35000 eligible under 80 D.No bifurcation should be there.Every additional polcy costs insurance company Rs 1000.Let us save it.
2.Co Payment clause under senior citizens policy is only applicable to senior citizens.Are we trying to please the senior citizens by giving by one hand and trying to take away the benefit by 2 hands. Let the insurance co's have uniform rules for all age groupes.

2.

New India pays penalty for not renewing the health insurance policy

The Hindu ,has carried the following news item.

The Madras High Court has imposed a fine of Rs.10, 000 on New India Assurance Company for refusing to renew insurance policies of a septuagenarian couple because their son had shifted the policies of other, relatively young, family members and his employees to a private insurer. Dismissing a writ appeal filed by the company before the Madurai Bench, a Division Bench, comprising Justice A. Kulasekaran and Justice P. Murgesen, said such arbitrary denial would defeat the objective of medical claim insurance policies. On the appellant’s contention that nobody would take the “risk” of insuring aged persons in the wake of stiff competition between public sector and private insurance companies, the Judges said: “It is immaterial whether a government company is having monopoly or not, but arbitrariness should not appear in their actions and decisions.” Concurring with S. Srinivasa Raghavan, counsel for the insured, the Bench said the reason cited for not renewing the policy was invalid and contrary to basic principles of insurance law.


We in www. healthinsuranceindia.org feel that New India ,the largest insurance company of our country should look at renewal of such policies with a liberal view and should get the goodwill of the masses.They release ads in print media and spend crores of Rupees but do not realize that one such judgement against them and being covered in a reputed paper The Hindu brings down the brand equity of New India.

Senior Citizens Health Insurance -should it come under pool

Senior Citizens Health Insurance -should it come under pool ?

This idea is being considered by IRDA as well as Insurance companies in the light of the fact that claims ratio is high.The same plea was used when third party insurance of vehicles was being considered.

The service level which the Indian Customer is getting with respect to third party insurance cover of 2 wheelers is well known.

Let us be prepared with same thing in the case of health insurance of senior citizens .With no insurance intermediaries in between we foresee less number of proposals being received by the companies ,hence issued.No one to push the proposals to be converted into policies.

Rs 15000 paid for health insurance of your parents can get you rebate

The Finance Minister has announced additional limit of Rs 15000 provided you have paid the same for health insurance of your parents.

We welcome this.

When we come to practical aspects then the points arises are;

1.Insurance co wants parents to be the proposer under senior citizen policy and the proposal form should be filled up & signed by parents only.
2.The cheque should be issued by the parent.


While Income Tax deptt wants that premium should be paid by the income tax assesse only.

This means that parent will pay and get the rebate.

Let us see who changes the rules
Insurance company
or
Income Tax deptt.

Let us hope we do not have to wait for 12 months for change in rules.