Jehangir Gai, Consumer Activist: Yes
Insurers don’t understand the objective and history of mediclaim policies. Healthcare is the responsibility of the state. But the budget allocation for healthcare is extremely low. Facilities in government hospitals are poor, as is the ratio of beds and doctors to patients. In this backdrop, medical insurance policies were introduced by nationalised insurance companies. The objective was to enable citizens to get access to affordable healthcare in private hospitals. The scheme was not meant to be a profit-making one.
The regulator has lost sight of the objective of mediclaim. Instead of protecting the insured, it is allowing insurers to discontinue existing policies and compelling the insured to migrate to another scheme. The change allows insurers to hike premium of the “new product”. The Supreme Court judgement that a policy must be renewed on identical terms and conditions so long as the insured pays the premium and does not commit any fraud, is violated.
Anand Roy, Joint Managing Director, Star Health and Allied Insurance: No
Accumulated savings can supplement any shortfall due to co-pay clauses and sub-limits. However, these are unlikely to be adequate to take care of hospitalisation bills over the long-term. It is true that premiums for senior citizens have been increasing over the years, but the hikes are linked to healthcare costs. Health insurers are commercial entities that have to ensure the sustainability of their businesses too.
All our plans, premiums and modifications are filed with the Insurance Regulatory and Development Authority of India (Irdai). Any premium revisions happen only after the regulator’s approval. Since portability is allowed, senior citizens can compare policies and migrate to a cheaper one. Dropping out is not a solution. Our Star Senior Citizen Red Carpet Health Insurance Plan continues to be one of our best-selling products, which means that our customers continue to find it viable.
Tapan Singhel, MD and CEO, Bajaj Allianz General Insurance: No
Health insurance, in fact, becomes even more critical as one ages because health issues tend to increase. Also, as healthcare costs spiral, the need for adequate health cover is becoming more important. One needs access to quality healthcare.
An easy way to mitigate the impact of health costs is by purchasing a good senior citizen health insurance plan. It is, of course, advisable to have health insurance from very early in one’s life, but I would say it’s never too late to be financially secure. We also recommend that customers buy a topup cover along with the base, regular health insurance policy, as it can come in handy in case of a large claim and is fairly inexpensive.
Sanjay Kedia, Country Head and CEO, Marsh India Insurance Brokers: Yes
Ideally, senior citizen health plans should offer programmes to encourage healthy lifestyles and provide access to care beyond hospitalisation. For example, for ongoing treatment—consultations, health check-ups and so on. They should also cover chronic conditions such as diabetes, considering its prevalence in India. In addition, such plans should provide healthcare-at-home facility. Barring a few insurers, most plans do not cover expenses beyond regular hospitalisation. This is a classic case where we need to build plans which are more inclusive and encourage more participation, get leverage of economies of scale to keep cost exposure low and make the programmes sustainable.
Preexisting diseases are not covered under individual health insurance policies, but are covered under group health policies. Most senior citizens are out of corporate health plans after retirement and many companies have discontinued programmes that fund the cost of parents’ insurance. This adds to the challenge.
We must focus on encouraging people to take individual health policies early in life. If such plans promote good health behaviour through rewards or incentives, we will indirectly create better situation for current and future senior citizens.
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5 Comments on this Story
Padamnoor Pradeep475 days ago
Insurance companies are ripping off the public. Society as a whole should have been taken into account while fixing premia. By increasing the senior citizens premia, insurance companies have ensured that the seniors don''t take insurance and so the insurance company now need not pay for them after taking the premia for last so many years. This has to be brought under price control like government did for stents.
Nikhil475 days ago
We need to privatise insurance and healthcare for cheaper healthcare and insurance
Venkatasubbaiah Basaralu476 days ago
Sir. Senior citizens and Super Seniors are in dire need of funds for daily medical needs. All states have not intriduced 7th pay commission and consequently getting low pension I.e.,that too lower starata of income groups.
This had hit hard.They prefer to pay certain amount as a premium to health insurance company. lot of advertisement coming but no government guarantee.How can one relay on these. That too insurance company have hidden agenda which is not possible to the understand utill the go for hospitable to get treatment. Some one had to take up this MATTER WITH GOI HEALTH DEPARTMENT.They Alone can understand and do something and help the aged .I sincerely hope that our grievance would be redressed.