Health Insurance - A Fast Growing Segment in India

Due to the fast-paced world today, it is very difficult to stay up-to-date with the current health norms. As if the pace were not enough, the ease of doing things and increased accessibility to various services has more or less “crippled” the society.

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      Introduction

      The modern age - a mix of daily adventures, hectic work schedules, and whatnot. But one thing that accompanies all this is the underlying health concerns.

      The world has, over the years, witnessed unprecedented growth in various spheres - from the standard of living to technology. This growth also has and further led to an increase in the cost of availability too.

      This increased cost is not restricted to any one sector but is spread evenly across all the sectors. Healthcare is no exception making it India’s largest segment in terms of revenue as well as employment.

      Nowadays, the cost of treatment is exceeding the cost of being healthy. Therefore, various measures have been taken to ensure that these healthcare expenses don’t burn a hole in our pockets.

      What makes the health sector in India different and largely successful is the ease of not only purchasing a plan but also of claiming. With a claim management system having an efficiency of over 80%.

      The Network of the Healers

      For proper medical care and effective claim processing, there are several network hospitals linked together which each client is free to choose.

      Additionally, if a client chooses not to go for a network hospital, they ensure that all the charges incurred during the treatment are taken care of.

      From a simple blood test to complex surgical procedures, healthcare insurance providers ensure that every requirement for a client’s healthy future is taken care of.

      Hiccups? Got you covered!

      Okay then! Read the papers, signed the policy and paid the premium. But that’s just not it! What if a client decides to claim his/her health insurance and the treatment costs him/her more than what he paid for?

      Such situations do come in the process of medical eventuality now and then. But that’s not the end! In an event where the costs are greater than the sum insured, the client has an option to just top-up his/her plan.

      Top-up plans provide additional coverage and act as the spare tank for your vehicle while also ensuring that the clients’ do no face a financial crisis. These plans are meant to provide greater flexibility and act as a backup.

      Getting a top-up plan is not restricted to having existing health insurance or to the company from where the existing plan has been purchased.

      These plans are very flexible and include several members of the family. Additionally, these plans can also be converted to a basic plan.

      Features of Healthcare Plans

      Health Insurance plans today target a wide number or groups of people. Be it children, students, parents or senior citizens; there are plans to suit everybody.

      Few basic features covered by healthcare plans are:

      • Out-patient Services
      • Accident and Emergency Services
      • Neonatal and Maternity Services
      • Hospitalization
      • Behavioural Health Treatment
      • Prescription Medicines
      • Rehabilitation Services
      • Laboratory Services
      • Chronic Disease Management
      • Paediatric Services

      In addition to the above-mentioned features, healthcare plans also provide the following benefits, to name a few:

      • Wide Coverage
      • Long-term Coverage
      • In-Patient Hospitalization
      • Pre and Post Hospitalization Care
      • Day-Care
      • Domiciliary Treatment
      • Organ Donor Expenses
      • Cash Benefits
      • Ambulance Cover
      • Critical Illness Cover

      These features and benefits act as a honeypot for the people, making them purchase the healthcare plans at nominal and competitive prices.

      Claim Settlement Process

      As easy the process of purchase of a healthcare plan is, the same must be true for the claim settlement process also. After all, who would want to get stuck in the tedious process when already suffering from a health issue.

      To obtain the services covered in the healthcare plan, healthcare policyholder needs to submit a request with the healthcare provider. This can be achieved in two ways:

      1. Direct Claim Settlement (Cashless Treatment)
      2. Reimbursement of Expenses

      When a policyholder submits a request, the network hospitals contact the healthcare provider, and the healthcare provider verifies the claim documents and establishes the authenticity of the case. A field doctor may also be assigned to verify the treatment prescribed.

      After the completion of the verification process, the concerned medical team approves the claim request.

      However, even if the claim request is legit, the claim request may be denied in the following cases:

      • Incorrect filling of details
      • Untimely request for claim settlement
      • Lack of relevant documents
      • Forged claim
      • Previous health issues not covered in the policy document

      Proper documentation and disclosure of the facts lead to a smooth and convenient claim settlement. Incorrect facts and wrong intents usually add to the grievances one is already facing.

      Reasons Behind the Growth

      According to the latest report by IRDAI, the healthcare industry can see a boom and is expecting an increase to INR 8.6 trillion. Medical tourism also is not far behind with predictions of up to 25 percent growth.

      One of the main factors behind such exponential growth of this segment is the never-ending demand. The healthcare industry in India provides medical care at competitive prices as compared to its western counterparts.

      Another significant reason for the growth of the healthcare industry is the rebate provided under Section 80(D) of the Income Tax Act.

      There has also been an increase in various diseases, which has led to a rise in medical costs. This rise in medical costs has convinced people from all groups to purchase a healthcare plan suiting their needs.

      Additionally, the rise in medical costs and cost of treatment has led to inequity in access to healthcare services.

      Also, the per capita expenditure on public health increased to INR 1,112 in 2015-16 from INR 621 in 2009-10. The center to state ratio of the expenditure on public health in 2015-16 was 31:69.

      Various health programs launched by the government on a national level have also played a vital role in handling most of the serious health concerns, and several communicable and non-communicable diseases.

      The Final Words

      Concluding the facts presented, it is evident that healthcare industry indeed plays a vital role in today’s world. However, the current healthcare infrastructure indeed paves the way for betterment in services and care.

      Disclaimer : *Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by an insurer.

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      Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in

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      *We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30- minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881.

      *Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. Policybazaar does not provide any medical or surgical advice or diagnosis and is not responsible for your interactions / treatment by a medical practitioner/hospital. Please consult a registered medical practitioner for any medical or surgical advice. The Information that you obtain or receive from Policybazaar, and its employees, or otherwise on the Website is for informational purposes only. As per the Insurance guidelines, you are allowed to cancel the policy with-in 30 days from the date of Issuance of policy.This option is available incase of policies with a term of one year or more.

      *All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.

      **All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws. GST Exemptions depend on fulfilment of qualification criteria and submission of relevant documents.

      *₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.

      *₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases

      *₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.

      *₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.

      *No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.

      *The values taken for effective cost calculation are indicative values and may change as per the selected plan.

      *Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.

      *Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.

      *The scope of coverage may vary from plan to plan.

      ~Source: Google Review Rating available on:- http://bit.ly/3J20bXZ

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      Tax Benefits are subject to changes in tax laws. GST Exemption depends on fulfilment of qualification criteria and submission of relevant documents as required by the insurers. For more details on risk factors, terms and conditions, please read the sales brochure and applicable rules and regulation carefully before concluding a sale.

      STANDARD TERMS AND CONDITIONS APPLY. For more details on risk factors, terms and conditions, please read the sales brochure carefully before concluding a sale.

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