What is HealthInsurance?<br />Health Insurance provides cover against loss from illness or bodily injury. It can pay for medicine, visits to the doctor, hospital stays, other medical expenses and loss of earnings. It depends on the conditions covered and the benefits and choices of treatment available on the policy. A fee called ‘premium’ is paid for advance health coverage.<br />Buying a Promise<br />Types of Health Insurance Plans:<br /><ul><li>Group Insurance Plan– for groups like employees of a company, members of an association or a co-operative society and so on.
Floater Insurance Plan - can be availed individually or by all the members of the family. It provides single premium for the entire family.
Unit Linked Health Plan - such plans combine health insurance with investment and pay back an amount at the end of the insurance term. The returns of course are dependent on market performance.</li></li></ul><li>HealthInsurance further categorized<br />Private<br />Risk rated & offered by commercial organization<br />Social<br />Non risk rated & initiated by Govt.<br />Community Based/ NGOs<br />Leading health care insurance companies are constantly coming out with new plans to meet the requirements of their customers.<br />
The State of HealthCare in India:<br />India’s healthcare infrastructure has seen steady improvement in the recent past, but much remains to be accomplished.<br />Government spending is less than 25% against the average spending of 30 -40% in other neighboring countries.<br />Healthcare providers have expanded their operations considerably and stand-alone health insurance products are now sold by general insurers and life insurers, as well as by new specialist health insurers. The third party administrator (TPA) landscape has also undergone noteworthy changes in the past few years.<br />Healthcare costs in India account for 5% of GDP, 80% of this is private out-of-pocket spend. With hospitalised Indians spending almost 60% of their annual expenditure on healthcare, the need for good quality, affordable health insurance is already high.<br />
HealthInsurance Market size and Growth Rate<br />
Mixed perceptions about<br /> Health Insurance in India<br /><ul><li>Requirement of people over 45
Getting claims is difficult and important ailments not covered
Meant for the rich, educated or those in business
A way to take care of responsibilities and be self reliant</li></ul> Negative Perception<br /> Positive Perception<br />
What you spend on your health:<br />Indirect costs such as travel, lodging etc add to financial burden and most often these expenses are overlooked while planning for medical expenses.<br />
Why do we need HealthInsurance?<br />Having Health Insurance has become the need of the hour for several reasons:<br /><ul><li> Change in lifestyle and attitude have made Indians </li></ul> more prone to health issues<br /><ul><li>Rising medical costs
Keeping pace with customer needs while achieving </li></ul> profitability.<br />
HealthInsurance: Challenges<br /><ul><li> Limited Influence over healthcare delivery </li></ul> mechanism<br /><ul><li> Limited bargaining power
High claim ratio - Insufficient data on consumers & disease </li></ul> patterns, absence of standardization of healthcare costs & <br /> significant levels of frauds leading to under-pricing of insurance <br /> products and higher value of claims<br /><ul><li> Low level of consumer awareness
TPAs facing funding support resulting in delays </li></ul> and impacting the claims disbursement time.`<br /><ul><li> Low health insurance penetration and lack of </li></ul> affordability for low income consumers<br />
Government Initiatives<br /><ul><li> CGHS Schemes for Government Employees