India spends around 6.5-7% of its GDP on healthcare, with 1.5% coming from the government sector and 4.7% from the private sector. Healthcare provision is a shared responsibility between the central, state, and local governments. Most healthcare in India is provided by private sector facilities operating on a fee-for-service basis. As healthcare costs have risen dramatically in recent decades, health insurance has become increasingly necessary for Indians to manage family healthcare expenses, especially in retirement when most serious age-related illnesses occur. However, health insurance also faces issues like low awareness, exclusions of pre-existing conditions, high claim ratios, and overutilization of services.

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Athif Abdul Azeez
INSURANCE

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India spends about 6.5% to 7% of GDP on Health
care.
Out of this 1.5% is in the Govt. Sector and 4.7% in
private sector.
Provision of Health care in the Country is the shared
responsibility of the Centre, State and Local
Governments.
Includes beneficiaries covered under ,Army,
Railways,self funded,PSUs and Insurance products.
Most of the health care providers in the country are
in private sector and are on fee for service basis.
Indian Scenario

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Shriram General Insurance first insurer to buy company abroad
Shriram General Insurance has become the first private insurer
to make a foreign acquisition with the purchase of a large chunk
of share in Philippine non-life company Monarch Insurance.
This is the first overseas insurance transaction after the
insurance regulator in May 2013 allowed domestic companies to
do business in other countries.
Life insurance sector sees uptick in growth in Q2
Insurance Regulatory and Development Authority (IRDA)
member (life) Sudhin Roy Chowdhury said the life insurance
sector has seen an uptick in growth in the second quarter of this
financial year (2013-14) after three consecutive years of slump.

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Many articles and Government of India’s
document on the subject reveals starling facts
about the state public health and the health
insurance scenario in India. Some of them
are:
 71% of all deaths are due to Cancer,Health
attack, Stroke and renal failure.
 About 7 million people in India suffer
from one form or other heart ailment.
 Out of this 10% need bypass surgery.
 Treatment for all these ailments costs
between Rs. 3 Lakhs and Rs.5 Lakhs,
which is beyond the reach of middle class
population
Indian Scenario

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Problem area is after retirement.
Some charitable trusts or individuals try to
contribute in the delivery of Health care to the
needy people.
Traditionally, Indians have been a close knit society.
In cases of illness the earlier joint family system,
tendered to give best of the comforts to the sick
persons – cost of giving such care was not an issue.
With the change in times all that have changed.
Expensive hospital , expensive treatments and
medicines have come to stay.
Indian Scenario

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Span of life increasing.
More serious diseases occur during old age I.e
between 60 & 80years
This age group is without any Insurance cover
back up.
No social Security scheme of Government for
providing healthcare treatment.
Tremendous escalation in the Cost of
treatment
People needs to make provision to manage the
economies of scale needed to manage the
health of the entire family. Hence the need for
health insurance arises.
Indian Scenario

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Some concerns,issues and challenges:
 Low level of awareness.
 Pre existing conditions and other
exclusions.
 Up front payment to hospitals
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Reimbursement policies
Claims procedure
 Service standards.
 High Claims ratios
 Over utilisation of services.
Issues and concerns

8. THANK YOU