Sunday, February 13, 2011

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 any claim due to same disease would be non payable for 4 yrs).

The question before us with example is :

Person 'A' having policy for Rs 2 lakhs and paying premium of Rs 2800 per year lodges claim for Rs 1.80 lakh and the same is paid. Next year he wishes to change to another company 'I' by using portability clause.Why should the company 'I' take a client with preexisting disease .The practical scenerio will be that 'I' will not accept the proposal form from 'A'.

The consumer does not have any option because at present the insurance companies are not bound to issue rejection letter or non acceptance letter for returning the proposal form.If the same situation continues ,which we understand is going to be then the client will have no document to complaint to any body for want of the same.

This has been happening with senior citizens when someone above 65 or say 70 yrs for last so many years. When he submits proposal for policy under Varisht Bima the proposal form is not accepted by the Insurance companies.This is the reason that if 100 policies are issued to 60 yrs old age group then the policies issued to 70 yrs old age group (we are talking of new policies not renewal of policies ) come down to 1 or even less than 1 .The underwriters sitting in the branches say that they have instructions to not to underwrite policies for those who are above 65 or 70 yrs.The best thing is that no record is maintained in these branches that how many such proposals were returned by the them in their branch.

If the precautions are not taken in this regard then let us be prepared that portabilty of insurance policy for persons with preexisting diseases is going to be sabotaged by the same underwriters and we will be at same level where we are at present.

If a person is normal then even now many companies have been accepting the proposals or issuing the policies with continuity for healthy persons.The problem is mainly with those persons who have lodged claim in last 2 years.

We will welcome the comments from you .You may like to suggest how this issue should be handled by those who are drafting the portabilty document or notification ,which will be implemented from July 1,2011

Wednesday, February 2, 2011

The Emperor of Maladies:A Biography of Cancer

The Emperor of Maladies:A Biography of Cancer

It 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 programme
2.Initiate sexual health education to prevent sexually transmitted cancers like cervical and oral
3.Encourage vaccination
4.Conduct mammography and screening of vulnerable women for breast cancer and those above the age of 50
5.Start screening for and vaccination against Hepatitis B that causes liver cancer
6.Create centralized systems modeled on comprehensive cancer centres in the US that allow researchers to share data and engage in high quality clinical work.

Out of these points 3, 4 & 5 are the ones which can be covered if the patient is covered under preventive care or is eligible for OPD treatment.

Few rupees spent on these by insurance companies can result in saving large number/amount of claim, which becomes payable when the insured has to be treated in specially/super specially hospitals for cancer.

We feel that the time has come to issue health insurance policies with OPD coverage.