Buy Health Insurance to Improve your Health

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Recently, we came across news in an online Publication, business-standard.com

Buy Health Insurance to improve your Health

You need not shell out the big bucks to be pampered. Buy a health insurance and enjoy luxury treatment at a spa, join a gymnasium or a yoga centre and get the necessary incentives that suit your budget.

Insurers, including ICICI Lombard General Insurance Co Ltd and Bajaj Allianz General Insurance, are tying up with yoga centers, gyms and spas to provide policy holders an opportunity to improve their health — and looking for avenues to sell more heath insurance. Some of the other insurers are also exploring collaborations with these centers.

“We can pass on the benefit of these initiatives if policyholders start taking preventive measures,” said Datta. “Globally, the benefits are transferred to policyholders in terms of discount in premium. It may happen in another two years in India also.”

To read the full news, click here

Experts from Medimanage.com give their opinion:

KS Sankar:

K S Sankar from Medimanage.com

I would however suggest that the insurance companies, rather than carrying out these initiatives themselves, will stand to benefit by outsourcing these activities to entities enabled to carry this out better. Reasons:

1)      Core competencies: Insurance companies’ core competencies lie in underwriting, not preventive health management.

2)      Customer perspectives: We live in a world where, for all that it is a good to do thing, the mere fact that it is rolled out by the insurance companies who would also tomorrow determine admissibility of my claims, makes me suspect motives. Is it that the insurance company is seeking to establish I am non-compliant with something, using which they could say ‘no’ to my claim.

3)      Focus: Except for Apollo Munich, the other insurance companies are not even dedicated health insurance companies. This activity would obviously not be an activity of prime focus for them.

4)      A lone tree does not make the woods: Just a visit to a spa or participation in gym exercises or yoga is only a part of the more wholesome approach – diet, lifestyle modification, etc. need to be integrated.

5)      Non-specific: Each individual needs a customized holistic prescription of the above combinations. To dish out memberships as panacea for all will not be the most effective way to ensure good health.

6)      Sustained involvement of the beneficiary: Most of the endeavors mentioned here seem merely to take the horse to water. Mere providing a spa/gym/yoga centre membership does not ensure the beneficiary will work through the fitness regimen. The woe of many a gym, we know, is the very high drop out percentage.

To ensure success in this, the following are essential:

a)      Thorough knowledge of pro-active health care and health insurance.

b)      Working dedicatedly in this sphere so that focus is not diffused.

c)       Ability to customize lifestyle modifications that are right fit for each individual.

d)      Interactive IT driven robust processes that will gently but effectively monitor and help the beneficiary through the fitness regimen. 

It would make better sense for these insurance companies to outsource these activities to an entity that has all the above capabilities. This entity could, on one hand, guide and monitor the beneficiary through the regimen and on the other, provide compliance reports to these insurance companies – with complete knowledge of the beneficiary, of course.

Sudhir Sarnobat:

Sudhir Sarnobat from Medimanage.com

Though the moves by the insurers would be called visionary & pragmatic, if these are looked at as remedies for immediate claims reduction, it would not happen so.

The real reasons for current higher claims ratio are:

  • Faulty pricing – The current premium rating emanates for old claims data which is hiked by certain percentages over a period of time. The corporate health insurance, which contributes to 50% total health insurance premium & around 70% of losses, is still priced differently when there are other portfolios like Fire & marine that are bundled together. The pricing across all customer segments should be based on stand-alone basis only.  
  • Unrestricted covers – This pertains more to the corporate segment where the maternity cover or pre-existing cover is offered at nominal premium which brings in huge losses. Also the optional parental cover is also another drainer which brings in anti-selection for the insurer.
  • Uneven spread – Over a period of time, the average age of the insured members is on rise which shows that either more old people are getting the insurance cover (which would bring in claims in immediate future) or not enough young people (below the average age) are buying the health insurance.
  • Low penetration – The low penetration remains a big concern as more than 90% population (among those who can afford insurance) if still uninsured. More than 85% of the payouts at the hospitals remain out of pocket.  

The tie-ups with Gyms are flimsy & one need to create more penetrating program if real change is expected out of such efforts. The gyms have 90% drop outs & that’s how they make their money & remain viable. The diagnostics tie-ups may bring in other diseases which may warrant hospitalisations at the behest of the doctors (read blog by Dr. Aniruddha Malpani here)

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