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  1. Health insurance: Outpatient coverage will be a big bet in 2018

Health insurance: Outpatient coverage will be a big bet in 2018

At present, 27% of Indians possess health insurance and majority of these are covered under some government or corporate scheme and only 5% possess any form of private health insurance.

Published: January 10, 2018 2:42 AM
health insurance, challenges for health insurance sector, challenges for insurance sector in 2018, health insurance risks, health insurance pre cautions To bring in more customers into the fold, we saw disease-specific and wellness linked covers being launched by a few players.

By-Ashish Mehrotra    

At present, 27% of Indians possess health insurance and majority of these are covered under some government or corporate scheme and only 5% possess any form of private health insurance. To bring in more customers into the fold, we saw disease-specific and wellness linked covers being launched by a few players. However, with the increasing uptake in medical cover by individuals, only the most focused players will survive. The need of the hour, given the rising medical inflation and escalating healthcare costs, are comprehensive products, with limited exclusions and lowest waiting periods, which are easy to understand, given the abysmal level of health insurance penetration in the country.

Health insurance this year

Outpatient coverage will be a big bet in 2018. Health insurance needs to evolve to become an intrinsic part of customers’lives. While we have seen added features and expanded scope for health insurance products, these (products) need to become more comprehensive and usable to attractmore buyers. At present, claims are basis IPD treatment but we expect greater work and development in the space of OPD coverage.

Health savings account

Most existing health insurance plans in India only offer in-patient coverage. There is no ecosystem available to manage out-patient expenses such as OPD, pharma bills and diagnostics. Given the potential increase in healthcare expenditure over time with an ageing population and disease burden shift from communicable to lifestyle diseases, it is imperative to look at options for building a corpus which can be utilised by individuals for their healthcare needs. The industry is already strongly contemplating the introduction of “Health Savings Account” in India with a focus on financial security in the wake of medical emergencies.

Products for younger people

Young customers are now increasingly demanding interactive and better experiential benefits for goods and services. They expect the health insurance players to deliver much higher value and partner them in their quest for a healthier lifestyle. Products will have to be created keeping the younger audiences’ needs in mind, and the delivery/ outreach method would also need to evolve to be able to tap the right audience at the right place and time.

Greater technology influx

Using predictive analytics, companies will aim to unleash the power of intelligence to process complex data source variables and convert them into relevant data for actionable insights. This would help them predict what could happen next and what the best decision should be. In the insurance industry, predictive consulting is offered to customers to facilitate 24-hour customer service and this will greatly define the customer experience in the coming years.

The insurance sector is focusing on Blockchain technology to empower the future of insurance. Blockchain will bring greater participation in the health ecosystem, bring more agility and speed in executing transactions. It will also help with consistency in health records management for the customer.

Digitalisation and wearables

In December 2017, Irdai set up a working group to examine the role of wearable devices in risk assessment and product design. This will allow companies to include features rewarding customers based on data collected from wearable devices or mobile apps.

Today, the biggest complaint against health insurance is that there is no differentiated ROI for healthy customers who maintain a healthy lifestyle and have no claims. In the absence of accurate data about customers’ health parameters, the only way companies can reward such customers is by offering a higher sum assured at the time of renewal. But if companies can access customers’ vital physical statistics and track their physical activity, then rewarding and encouraging customers to maintain a healthy lifestyle will become easier. Companies can also offer customers guidance and advice on healthy living based on this data.

The writer is MD & CEO, Max Bupa Health Insurance

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