Let Us Welcome Cigna ttk Health Insurance in India

It is always good to have entry of new Insurance Company, especially Health Insurance Company. The fifth standalone health Insurance company of the country “Cigna ttk Health Insurance Company Ltd" will soon be entering the Indian market.

Cigna ttk health Insurance Co. Ltd has received the regulatory licence from the Insurance regulator IRDA on Nov.13, 2013 and soon it will start operations in the Indian market. Its head quarter will be in Mumbai.

Its a joint venture between U.S health service giant Cigna Corporation & an Indian conglomerate- ttk group.

We in Insurance Industry have been familiar with ttk as a TPA under the name of ttk Health Care Services Pvt. Ltd.

We are pleased that at least 1 US Health Insurer has entered the Indian Market. As we know that out of 4 -3 Insurance Companies have foreign affiliation with non US companies :

Star                                            Oman

Max Bupa                                    UK

Apollo Munich                              Germany

Religare Health                              ---

According to Mr. William L. Atwell, President of Cigna International “Entering in to India is an exciting new chapter for Cigna International, as we have the Innovative solutions to help the Indian Consumer meet the important health challenges. We are committed to improving access & quality of care while reducing costs.”

As per the plans of Cigna ttk - it will set up an innovative distribution network. It plans to leverage its network of pharmacies & physicians to sell its health insurance plans. The simple health Insurance products would be sold over the counter. We as www.healthinsuranceindia.org feel that they (Cigna ttk) should not violate IRDA regulations on Corporate Agency/ Agency i.e product should be sold by trained professionals or organizations say Insurance Brokerage Firms. Recent penalties on Insurance Companies/ TPA’s/ Insurance brokerage Firms are an eye opener. We are sure Cigna, a great brand in US will not like to take any wrong step.

We understand that Cigna ttk product will be a box product & the buyer would be able to get a policy kit across a counter. This is similar to what Reliance General introduced in 2005. There may be a simple product for which medical tests are not compulsory criteria and the documents can be submitted online once the customer reaches home.

According to  Mr. Sandeep Patel, Managing Director & Chief Executive Officer of the company–“We will strongly leverage Cigna’s Global Health Insurance services, experience & expertise as well as the trust of the TTK group to offer an innovative suits of products.”

Let us hope that we as consumers will get special treatment from this company. Indian market has been waiting for introduction of following:
OPD Treatment
Dental Care

Cigna has been doing this in US for a long time. If they introduce these products/features  it will be a good achievement & initiative.

If it is going to be a normal product then customers are at present & having a wide choice available.

The Changes in Oriental Happy Family Floater policy’s guidelines result in increase in premium for many families as high as 86%

Till Nov. 03, 2013 the Oriental Happy Family Floater policy‘spremium calculation was unique & was very popular as in this the premium was calculated based on the age of the proposer. As a result the product was popular among large families comprising of self/spouse/parents/parents in law and even children below 21 years.

The revised calculation method announced by Oriental Insurance Co. Ltd. on Nov. 4, 2013 is:

·        If one generation is covered the primary member would be the person of higher age

·        If two generations are covered i.e. husband, wife & children, primary member would be the person of highest age.

·        If three generations are covered by excluding the senior most generations, the highest age member will be the primary insured.

This has affected the premium amount a lot.

Let us see this with example

Let us take an example- Suppose a family of 4 members, husband (35yrs), wife (33 yrs), mother (60yrs), father (62 yrs) was insured for Rs. 6 Lakhs of sum insured. According to the old rate their premium would be 20490 Rs. But, according to the revised rate its premium will be 38200.

Oriental Happy Family Floater Comparison Rates
	Age	Old Rate for Rs. 6 Lakhs	New Rate for Rs. 6 Lakhs
Self	35	Rs. 7,140	Rs. 1,430
Spouse	33	Rs. 1,430	Rs. 1,430
Father	62	Rs. 7,800	Rs. 31,220
Mother	60	Rs.4,120	Rs. 4,120
Total Premium		Rs. 20,490	Rs. 38,200
Total Premium after S.tax (12.36%)		Rs. 23,023	Rs. 42,922

So, we observe that a total increase of 86% in premium hasbeen imposed on this family.

Due to this high increase in premium rate this product has lost its attraction. Is it good or is it bad for the company – only time will tell. We foresee many families will use the portability clause to switch over to other companies.

Surprising, No Health Insurance Policy is available for Cancer Patients

India is having 30 Lakhs Cancer Patients and every year 8 Lakhs new patients get added to this number.

According to Mr. R.K.Chaturvedi, Adviser to Vedanta’s Cancer Hospital project.

“The number of cancer patients in India is rising alarmingly and from year 2020 onwards, the nation will add more than 20 Lakhs new cancer patients every year,”

It is surprising to know that not even a single Insurance Company is ready to provide Health Insurance for patients who are having pre- existing cancerous condition.

The Raheja QBE, who offers a product separately with the name “Cancer Insurance”, does not cover a pre- existing cancerous condition. They provide cover to the persons who have not been diagnosed cancer symptoms.

Some Life Insurance Companies as well General Insurance Companies offer Critical Illness Cover under which Cancer is one of the diseases. It means Raheja QBE has introduced a disfeatured Critical Illness product under the fancy name of “Cancer Insurance”. This product does not cover a pre- existing cancerous condition or patient. They provide cover to the health persons who have not been diagnosed with Cancer symptoms.

Now, here is a question that which is a better option for proposer or client.

-        To purchase a standalone Cancer insurance of Raheja QBE

-        or

-        To purchase a life insurance policy providing a critical illness cover. Here is a comparative analysis of the premium rate of two companies who gives cover against cancer.

TATA AIA: - CriticalIllness cover for the Sum Insured of Rs. 10 Lakhs for a person of age 35 will cost Rs. 8892.

Raheja QBE: - A person of age 35 to get cover against cancer for the sum insured of 10 Lakhs will cost Rs. 3060.

Therefore we can interpret that the Life Insurance plan for Critical Illness Cover may be much better & cheaper than standalone Cancer Insurance Policy.

Rajiv Gandhi Cancer Institute located in Rohini, Delhi has a scheme that those who are having no pre existing cancerous condition can make one time donation of Rs. 5000. They can have checkup and when required will be given free of cost treatment by this hospital in the event of person getting Cancer. 

Although, Rajiv Gandhi Cancer Institute is not Insurance Company but the initiative taken by this hospital needs appreciation.

World Diabetes Day is celebrated on November’14, Let us work towards diabetes prevention.

We as an Insurance Brokerage Firm have been always guiding our clients on importance of preventive cure in avoiding / keeping diabetes under control. Buying Health Insurance does not mean that we can neglect our responsibility of preventive care .It was interesting to see an informative article on diabetes prevention in Mint-Nov 12, 2013. According to it:

Eating of following:

• Apples and Avocado
• Jamun ( fruit)
• Karela (vegetable) Bitter Gourd
• Beans
•  Barley
• Cinnamon
• Walnuts
• Egg whites
• Pumpkin seeds
• Green tea
• Grapes
• Fenugreek
• Take in more vitamin C like Oranges, Strawberries, Amla, Lime and Broccoli
• Take diet full of green vegetables and fruits
• Kiwi
• Vinegar
• Salmon

Do not eat / avoid as far as possible

• Trans fats 

Reduce consumption of following significantly or bring it near to zero

• Sugar / sweets
• Alcohol
• Animal protein i.e. Chicken etc.

Do

• Walk in the morning for 60 minutes, if possible bare foot on grass
• Practice Yoga
• Zero in on your weight
• Regular exercise
• Meditation

Copy

• Healthy habits of healthy people around you and translate them into your life

We appreciate the focus of Mint on guiding it’s readers with such informative articles.

Why you should avoid Health Insurance Group policy of Banks?

It is from time to time we come across a standard query-Should I buy policy from a specific bank?

We have always taken the stand:

Avoid it as the bank may stop the policy due to various reasons:

·       Change of InsuranceCompany

·       Cancellation of policy by insurance company due to higher claims.

Recently we have come across from newspaper reports about  the  case of Dr. Abhay Bedmutha’s who  had an account with Nashik Merchant Co-operative Bank Ltd. and was issued a Personal Accident Insurance Policy .  When Dr. Abhay Bedmutha died then his wife was informed that policy was not in force as the bank had discontinued some time back. No intimation was given to client about this fact therefore client was left uninsured.

This Widow/Nominee took matter with Consumer Forum and The National Consumer Disputes Redressal Commission has passed judgement that Bank should pay the following:

              Insurance Amount              Rs. 5 Lakhs

       Compensation Amount             Rs. 3.50 Lakhs

                               ---------- -------------

                                                         Rs. 8.50 Lakhs

How many persons have the courage to take the case to Consumer Forum?

We come to the conclusion that do not buy policies through Bank especially if these are part of Group Policies.

Health Insurance sum assured should increase every 2 years – It is a sensible decision

Many a times our customers or clients ask us what should be the sum assured under Health Insurance policy? Should I increase the sum assured this time?

The logic demands that sum assured or Health insurance policy should be fulfilling the following criterion:
    (a)  Cover the risk to a reasonable extent – need not be highest
    (b)  Should be Cost effective – where pocket permits

While in the case of motor vehicle sum assured (IDV) – goes down year after year due to depreciation / obsolescence of the vehicle, the situation changes for Health Insurance as t with increase in age of the insured the risk also increases and all of us (including Health Insurance provider )  know that it goes on increasing with passage of time .

The reasons are

As you grow older the need for hospitalization definitely increases as some diseases are age related and are bound to affect most of us and some examples are:
(i)        Hernia
(ii)      Cataract
(iii)    Prostrate
(iv)     Hysterectomy
(v)      Arthritis (Knee replacement)
(vi)    Many others Critical Illness like Cardiac / Cancer

 

We find that on the one hand need is increasing and at the same time up gradation of Medical Technology ( Equipment /diagnostic) results in availability of better treatment / painless treatment to the patient .Some of  examples of  up gradation of Medical Technology are :
(i)      Lasic Surgery ( day surgery ) vs. Traditional Cataract Surgery (3 days stay  in hospital )
(ii)     Advanced MRI  vs. MRI vs. CAT vs. X-RAY Digital vs. X-RAY
(iii)    Even  in Coronary Stent In plants you have choice of

Traditional Metallic Stents      Rs.40000
Drug eluting Stent                   Rs.150000 (higher by 275%)
Bio Degradable Stent              Rs.300000 (higher by 650%)

It is natural that Bio Degradable Stent will be better / more effective than Traditional Metallic Stents.   In Times of India – Oct 07, 2013. We came across good information from Mr. Sanjay Datta (ICICI Lombard).

 “Treatment costs have gone up by 50-60% in some cases such as arthritis and brain stroke. Several other ailments such as spinal cord disorders, heart stroke, and hip and thigh fracture have witnessed an increase of 25 to 50% in treatment costs”.

In the same context we have comment of Mr. Suresh Sugathan, Head of Health Insurance at Bajaj Allianz General Insurance.

“The costs of robotic surgery on average are 25-35% higher than conventional surgery. What typically happens is that the doctor offers the patient a choice between a traditional option and a superior technique”.

In Ria Insurance Brokers we have the experience of dealing with thousands of families and according to Mr. S K Sethi Director the finding is “When the patient / insured checks with many friends / colleagues / relatives every one will suggest – go for latest, go for best. This is the time one realizes the value of higher sum assured policy “

We in www.healthinsuranceindia.org and Ria Insurance Brokers Pvt. Ltd.  feel that we should always go in for use of modem advancement achieved in Health Care Technology / use of modem equipment as well as medicines.

We believe – “Even if the hospital is trying to use the newly installed expensive equipment extensively with a new to recover the cost – we should not bother. We always suggest / advise that sum assured should be reviewed every 2 years and increase it by 25% - addition to same policy or taking a new policy.

What ever may be the reason seeing the inflation in Health Care at 20% year after year it may be worth while for you to reconsider sum assured which you are have. If you bought the policy in 2005 for Rs. 2 lakhs then your sum assured in 2013 should be Rs.10.32 lakhs, say Rs.10 lakhs

Year	Rs.(in lakhs)	Increase 10%	Increase 20%
2005	2	2.2	2.4
2006		2.42	2.88
2007		2.66	3.46
2008		2.93	4.15
2009		3.22	4.98
2010		3.54	5.97
2011		3.90	7.17
2012		4.29	8.60
2013		4.72	10.32
2014		5.19	12.38
2015		5.71	14.86
2016		6.28	17.83
2017		6.90	21.40
2018		7.59	25.68
2019		8.35	30.81
2020		9.19	36.98

If you are continuing at Rs.2 lakhs + Rs.50000 or so of NCB – you are lagging behind and will have to shell out lot of money your own pocket or go for use of old technology /medication .when the need arises.

Do Hospitals overcharge from Health Insurance Patients?

We have been always hearing or reading that moment hospitals come to know that patient bills are to be paid by Health Insurance / General Insurance Company – they are very happy and they start overcharging. Insurance Foundation of India had brought out a cartoon in 2009 (www.healthinsuranceindia.org) which was highly appreciated by large number of people.





But Times of India carried a news during this week (September last week 2013) which is fact revealing as it proved whit facts & figures that if you are not covered then you are in a disadvantageous position and will end up paying very high.



We come to conclusion that with time market scenario changes and as a result of the same our belief also changes.
It is a good fact to know from this news and we will like more and more people will buy Health Insurance to protect their savings.

How to control Passive Smokers?

Should Health Insurance Premium be adjusted?

Sometimes you come across interesting facts in publications. Economics Times Wealth August 18-24, 2013 has carried the following information

56% is the difference between the premium of a smoker and a non-smoker for a life insurance policy. The question before us is:

 

If Life Insurance Industry penalizes a person by 56% then what is the figure for Health Insurance? Why not penalize family members / colleagues who are passive smokers and are being compelled to smoke? May be this will result in reduction of smokers in our country.