Health insurance needs to be simplified

NEW DELHI: Health Insurance needs to be simplified for it to be attractive for the consumer, was one of the key messages given by J Harinarayan, Chairman IRDA at the CII 3rd Health Insurance Summit organized by Confederation of Indian Industry (CII) here.

Delivering the keynote address at the Summit, Harinarayan said insurance companies need to work on database of hospitals and standardization of   hospitalization processes and also towards integration of billing systems.

A large number of claims may be rejected due to genuine reasons but it still sends a very bad message to customers. There is need for having core coverages without too much of product complexity as it tends to confuse customers, said Harinarayan.

Currently, health insurance is focused largely on hospitalization whereas hospitalization is only 1/3rd of overall healthcare costs. Insurers need to work on non- hospitalization healthcare costs, while taking care of moral hazard issues. Harinarayan said confidence in health insurance can be improved substantially by effective claims management.

Speaking on the occasion Chief Guest of the Summit B.K. Chaturvedi, Member, Planning Commission said 70 percent of expenditure on health is from the private pockets, with a majority from the rural areas. He emphasized on the need to expand health care mechanisms to rural and semi-urban areas.

He spoke about the need for investment in the two social sectors i.e. health and education, as being the focus of the Planning Commission's 11th plan. He called for a new approach to consumer awareness. Chaturvedi assured that policy implications of recommendations made at the CII Summit would be considered by the Planning Commission.

He pointed out that the current products focus is on inpatient expenses, whereas the bulk of expenditure is outside the hospital. Thus products should cover this as well.

Malvinder Mohan Singh, Group Chairman, Fortis Healthcare and Religare Enterprise and Chairman CII National Task Force on Health Insurance said Healthcare has to make transition from curative to preventive care over the next few years.

He said providers need to have minimum accreditation for ensuring minimum standards of care. Today this is largely missing. There is great need for investments in delivery network. Current network is not adequate, he pointed out. He said Insurers need to see that there are right checks and balances for payments Shobana Kamineni, Executive Director, Apollo Hospitals Group and whole time Director, Apollo DKV Health Insurance, said there should be focus on enhancing consumer experience in health insurance.

India Post News Service