Get <strong>₹5 Lac</strong> Health Insurance starts <strong>@ ₹200/<span>month*</span></strong>
Get ₹5 Lac Health Insurance starts @ ₹200/month*
Get ₹5 Lac Health Insurance starts @ ₹200/month*
250+ Plans 18 Insurance Companies
₹ 5 Lakh Coverage @ ₹ 10/day
7 Lakh+ Happy Customers

*All savings are provided by the insurer as per the IRDAI approved insurance plan. Standard T&C Apply
*Tax benefit is subject to changes in tax laws. Standard T&C Apply

Health Insurers Switch to Co-Payment Model as a Cost-Cutting Measure

Health insurance is one of the essential needs of today which helps one fight the escalating number of diseases. With a goal to keep health insurance premium pocket-friendly to the insured, the key players are gradually switching to the co-payment model. Co-payment model implies that the insured needs to pay upto 25% of the claim value and the balance amount is to be borne by the insurance company. This co-payment model has proved to be a win-win proposition both for the insured and the insurer. For the insured, opting for co-payment reduces insurance premium; for the insurer, it reduces the payable claim amount.

According to the stated model, the co-payment ratio for the policyholder varies from 10 to 25 per cent of the Sum Assured. E.g. if you purchase a health insurance policy with 10% co-payment clause and claim for an amount of Rs. 2 lakh then you need to pay a sum of Rs. 20000 from your end whereas Rs.180000 is paid by the insurer.

But other cost suppression measures have shown a significant downfall during the past year. These include application of sub-limits on claim amount for common illness like kidney stone or cataract treatment. Another concern from insurers end would be treatment cost charged by the healthcare providers to the policyholders. They need to insure that the hospitals should not elevate their fee structure.

After a thorough analysis, industrial experts mention about many insurance companies which have introduced co-pay clause in their individual health policies designed for senior citizens. Segar Sampathkumar, general manger of New India Assurance, stated that more than 20% of their health insurance policies have a co-payment clause.

In a recent interview, Sanjay Datta, head of underwriting and claims at ICICI Lombard General Insurance, quoted that policyholders tend to behave more responsibly when they are insured under a co-payment based policy. For instance, they might prefer a normal room over a deluxe room as they are supposed to bear 10-25% of the claim amount themselves. Co-payment model is expected to bring an overall betterment of health insurance. 

Written By: PolicyBazaar - Updated: 14 December 2020

You May Also Want to Know About

Best Maternity Insurance Plans

Best Maternity Insurance Plans

Best Maternity Insurance Plans Maternity or pregnancy is an important phase of life, and one needs to prepare in advance to embrace parenthood. Though rearing a child is an expensive affair and may require good financial backup to meet the requireme...
Health Insurance Claims Ratio- Things You Should Look Before Buying Health Insurance

Health Insurance Claims Ratio- Things You Should Look Before Buying Health Insurance

There has always been a doubt in customers mind about whether the private company will keep its side of the bargain i.e. it will settle the claim or not. A customer spends premium annually which will cover his medical expenses but there’s always ...
Best Health Insurance Plans for Senior Citizens in 2021

Best Health Insurance Plans for Senior Citizens in 2021

Best Health Insurance Plans for Senior Citizens in 2021 Considering the increase in medical inflation in India, buying adequate health insurance for your loved ones has become an absolute necessity. When it comes to your elderly parents, then it is...
Here’s the Difference between Health Insurance and Mediclaim

Here’s the Difference between Health Insurance and Mediclaim

Here’s the Difference between Health Insurance and Mediclaim Imagine you’re looking for a job change. You get an interview call for a job. What will be your plan of action? Will you get your resume ready and prepare for the interview or you wi...
Close
Download the Policybazaar app
to manage all your insurance needs.
INSTALL