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Why Medical Insurance needs Transformation in India?

Every year, nearly 65% of people head to a doctor for a routine medical check-up. It gives a chance for early detection and to figure out how to ward off any disease and ultimately keep them healthier. While it is sensible to go for a medical screening as early detection means timely treatment. But how many of us think about getting health coverage and securing the future of our loved ones?

A FICCI and KPMG report surprisingly mentions that only 27% of the people have adequate health insurance cover.

In the last 20 years, the health sector in India has made huge advancements. While the average life expectancy in India is now more than 67 years, Cancer is still one of the leading causes of death in India with nearly 2 million cases at any given point of time, 7 lakh new cases each year, and approximately 3 lakh deaths. Over 15 lakh patients fail to even get facilities for its diagnosis and treatment. And the WHO Reports further mentions that by 2026 India can have 14 lakh new cancer cases every year.

With the increasing number of Coronavirus cases in India and around the world the need for transformation is essential. As per the Department of Health and Family Welfare, Odisha there are 18,757 COVID-19 positive cases in the state, 5314 active cases, and 13310 recovered patients as of July 21, 2020.

It is acknowledged that the only way of handling health problems is through including it into the primary health care arrangements implying timely screening and the facility to avail the best medical treatment, and that is where ‘Insurance plays a big role’.  Medical insurance helps in securing your finances by paying for the staggering healthcare costs.

In India, while the health certainties are constantly on a rise, what is it that stops people from buying insurance?

A belief that it won’t happen to us and lack of awareness!

So, what can be done to change the face of health insurance in India?

Considering the number of uninsured people in our country, there is a significant growth potential for the health insurance sector that is already witnessing rapid expansion amid the COVID-19 outbreak.

Meeting Diversified Customer Needs

Healthcare is quite diversified, there cannot be one fit to all solution considering the vastness of our country. The need of the hour is to construct plans that cater to all the sections of the society and even the rural-urban population. To extend the reach, a lot of insurers are offering customized plans that cover coronavirus pandemic, plasma therapy for COVID patients, vector borne-diseases, cancer, diabetics, etc. The availability of these medical insurance plans online makes it even more accessible.

The health insurance used to cover in-patient hospitalization expenses only but now it covers pre and post hospitalization expenses, quarantine and make-shift hospital costs for coronavirus patients, medical check-ups, and outpatient expenses also. The insurers have now designed online health insurance premium calculator to ensure people have an idea of the premium cost.

Moreover, with the online purchase of medical insurance products, the comparison of insurance policies has been made much simpler as one can select the coverage benefits, provide all the details of the insured members, pay the medical insurance premium online and get the policy will be mailed on their registered email id. This helps customers follow social distancing protocols and minimize the risk of spreading the virus.

With the use of wearable devices, insurers are now offering a wellness program in which the insured is offered a discount on renewal premiums for showcasing improved health records. The aim of rewarding health-conscious people is to promote such habits and design personalized healthcare tools that help meet different customer needs.

Going Cashless

Almost every insurance provider nowadays offers cashless hospitalization in-network hospitals. As per the Insurance Regulatory and Development Authority of India’s (IRDAI) recent guidelines no network hospital can deny cashless treatment to the insured patients. Amid the coronavirus outbreak and post demonetization the trend of online payment services has also taken over.

These digital services provide transparency, convenience, and helps health insurers coordinate with healthcare providers and offer the best and affordable treatment along with the ease of digital transactions. Taking into consideration the present situation that requires people to follow social distancing norms, more and more policyholders are opting for cashless payment methods only.

Going High-tech

Not only the digitally enabled premium payments, but the policyholders can also have access to e-repositories for both health and life insurance. This digital information can be accessed on the go. There is nothing to worry about misplacing a document and can be used as a single point of reference when buying a health insurance product.

Amid the ongoing pandemic that shows no signs of ebbing yet, steps are also being taken to create digital offices where customers can interact with salespersons over an established mobile network. Medical consultations have also gone online as nobody wants to move out in public fearing the COVID-19 community transmission.

The use of chatbots to answer customer queries, customer sign up that used to be a time taking process earlier. Moreover, the government is planning to link the healthcare database with Aadhar in the interest of both customers and healthcare providers.

Some Recent Initiatives Post COVID-19 outbreak

Along with digital methods, it also requires to make it affordable and accessible to all, especially during such an unprecedented time of coronavirus pandemic.  The Insurance Regulatory and Development Authority of India (IRDAI) has already introduced some remarkable initiatives to ensure the best medical care to all, especially the expenses stemming from the Coronavirus treatment.

  • As per the IRDAI regulations hospitals cannot deny cashless treatment for coronavirus to the insured patients
  • Two standard health insurance products have been launched namely Corona Rakshak and Corona Kavach health insurance that will offer coronavirus treatment cover up to Rs 5 Lakh. The policy benefits and features remain common across all the health and general insurance companies. The policies are designed to cover the cost of PPE kits, masks, oximeters, ventilators, gloves, that add to the total hospital bill
  • Arogya Sanjeevani health insurance policy has also been introduced to reduce the ambiguity that people face when purchasing health insurance. It is a standard product that eliminated confusion among the buyers and all the insurers offer the policy with the same features and coverage benefits. It also covers COVID hospitalization expenses, modern treatment costs, as well as plastic and dental surgery expenses

A lot of Initiatives are already being taken by the Government and IRDAI under their ‘Sandbox Initiative’ to make insurance accessible to all. While the customer demands are constantly changing, the health insurance providers are implementing methods to transform the health insurance experience and bridge the gap between the insured and uninsured in India. And the Coronavirus pandemic leads to further transformation of the healthcare and insurance sector.

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