Health insurance


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Health insurance

  1. 1. Samiran kundu A-06
  2. 2.  Health insurance is insurance against the risk of incurring medical expenses among individuals. A contract between an insurance provider and an individual or his sponsor The contract can be renewable or lifelong in the case of private insurance, or be mandatory for all citizens in the case of national plans. The type and amount of health care costs that will be covered by the health insurance provider are specified in writing, in a member contract or "Evidence of Coverage" booklet for private insurance, or in a national health policy for public insurance
  3. 3.  In the late 19th century, "accident insurance" began to be available, which operated much like modern disability insurance. Accident insurance was first offered in the United States by the Franklin Health Assurance Company of Massachusetts. This firm, founded in 1850.
  4. 4.  Health insurance, as we know it today, was introduced only in 1912 when the first Insurance Act was passed. The penetration of health insurance in India has been low. It is estimated that only about 3% to 5% of Indians are covered under any form of health insurance. In terms of the market share, the size of the commercial insurance is barely 1% of the total health spending in the country.
  5. 5.  Health insurance is one of the fastest growing areas in the insurance industry with annual growth rate of 25%. Health Premium has risen to Rs. 11000 crores in 2010-2011. As per the recent reports from various agencies the health sector has the potential to become a Rs. 30000-crore industry by 2015.
  6. 6. According to World Bank Report 1 in 3 Person Will develop some life threatening cancer. 1 in 4 Person Will contact heart disease before they retire. 1 in 20 Person Risk the chance of having stroke before the age of seventy
  7. 7.  85 % of the working population in India DO NOT have Rs. 5,00,000 as instant cash. 14 % have Rs. 5,00,000 instantly BUT will subsequently will face a financial crunch Only 1% can afford to spend Rs. 5,00,000 instantly and easily. 99 % of Indians will face financial crunch in case of any critical illness.
  8. 8.  Let us look at what it costs in a good/ reputed hospital for treatment of Angioplasty Rs. 2,00,000 to Rs. 3,00,000 Open heart surgery Rs. 2,50,000 to Rs. 4,50,000 Liver Transplant Rs. 30,00,000 Kidney Transplant Rs. 18,00,000 to Rs. 30,00,000 Hernia surgery Rs. 30,000 to Rs. 60,000 Cancer-Chemotherapy - Rs. 7000 to Rs. 10000 per visit and number of visits may be 4 to 20 means that cost can be as high as Rs. 2,40,000. It is only that Health insurance policy taken by a person can take care of hospitalization costs of this magnitude.
  9. 9.  Premium: The amount the policy-holder or his sponsor (e.g. an employer) pays to the health plan to purchase health coverage. Deductible: The amount that the insured must pay out-of-pocket before the health insurer pays its share. Co-payment: The amount that the insured person must pay out of pocket before the health insurer pays for a particular visit or service.
  10. 10.  Coinsurance: Instead of, or in addition to, paying a fixed amount up front (a co-payment), the co- insurance is a percentage of the total cost that insured person may also pay. Exclusions: Not all services are covered. The insured are generally expected to pay the full cost of non-covered services out of their own pockets. Coverage limits: Some health insurance policies only pay for health care up to a certain dollar amount.
  11. 11.  Out-of-pocket maximums: Similar to coverage limits, except that in this case, the insured persons payment obligation ends when they reach the out-of-pocket maximum, and health insurance pays all further covered costs. Capitation: An amount paid by an insurer to a health care provider, for which the provider agrees to treat all members of the insurer.
  12. 12.  Apollo Munich Insurance Company Limited Bajaj Allianz General Insurance Co. Ltd. Bharti AXA General Insurance Co. Ltd. Cholamandalam MS General Insurance Co. Ltd. Future Generali India Insurance Co. Ltd. HDFC ERGO General Insurance Co. Ltd. ICICI Lombard General Insurance Co. Ltd. IFFCO Tokio General Insurance Co. Ltd. Larson & Toubro General Insurance Co. Ltd. Max Bupa Health Insurance Co. Ltd. National Insurance Co.Ltd. New India Assurance Co. Ltd. Oriental Insurance Co. Ltd. Raheja QBE General Insurance Co. Limited Reliance General Insurance Co. Ltd. Royal Sundaram Alliance Insurance Co. Ltd SBI General Insurance Co. Ltd. Shriram General Insurance Co. Ltd. Star Health and Allied Insurance Company Limited Tata AIG General Insurance Co. Ltd. United India Insurance Co. Ltd. Universal Sompo General Insurance Co. Ltd.
  13. 13.  Health Insurance Covers hospitalization when a patient is in hospital for more than 24 hours due to: Illness Accident Surgery requirement Symptoms, when diagnosis is been done, the costs covered are
  14. 14.  Room, Boarding Expenses in Hospital/Nursing Home Nursing Expenses, intensive care unit expenses, Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist fees Anesthesia Pre-Hospitalization Expenses Post-Hospitalization Expenses General Health and Eye Examination (Optional with extra premium) Local Ambulance Services (Optional with extra premium) Hospital Daily Allowance (Optional with extra premium)
  15. 15.  Treatment of illness at home by consulting doctor in your locality All diseases /injuries which are pre-existing when the cover incepts for the first time. Any disease other than those stated in the in clause contracted by the Insured Person during the first 30 days from the commencement date of the Policy. Injury or Disease directly or indirectly caused by or arising from or attributable to War, Invasion, Act of Foreign Enemy, Warlike operation (whether war be declared or not).
  17. 17.  If David Beckham ever stops being able to "bend it," his posh lifestyle will go on. His magic legs are insured for a cool $70 million
  18. 18. NFL player TroyPolamalu is famousfor more than hismoves on the field
  19. 19. Bruce Springsteenknows his voice is ahot commodity. TheBoss pipes areinsured for $5million.
  20. 20. Rolling Stone KeithRichards has hismiddle fingerinsured for $1.6million in case heceases to be able toflip people off ... orplay the guitar.
  21. 21. “If anything happened to my assets, I’d be outfor a few months and I’d probably be out amillion dollars,” “I thought I’d cover myassets… They’re my primary money makers.”
  22. 22. THANK YOU