Changing demographics, rising healthcare costs, limited healthcare financing, increasing government focus, and potential increase in FDI limit are factors expected to give a fillip to the currently low penetration of health insurance in India.

With 55 per cent of India’s population estimated to be in the working age segment (15-60 years) by 2025, income levels are expected to rise. Furthermore, level of healthcare awareness will also rise with increase in literacy rates, education and urbanisation. These factors will result in higher healthcare spending, bolstering a burgeoning demand for individual health covers. Complementing these changes, higher life expectancy, increasing per capita healthcare expenditure and limited financing will also drive the growth of this segment.

Due to the large premium contribution, health insurance business accounted for 22.25 per cent of the total pie of business underwritten by the non-life (including standalone health) insurers in 2012-13

The impact is already being felt – today health insurance is the fastest growing segment of insurance business. The total industry premium in 2012-13 was Rs 1.53 million with a growht rate of 16.56 per cent. In fact, the premium grew four-fold from Rs 0.2 million in 2005-06 to Rs 0.8 million in 2009-10, and was close to doubling in the last fiscal. In the next five years, the sector is expected to grow at a rate of 18-20 per cent.

Due to the large premium contribution, health insurance business accounted for 22.25 per cent of the total pie of business underwritten by the non-life (including standalone health) insurers in 2012-13.

The sector has witnessed significant developments in the last couple of years, with the introduction of innovative products, portability provisions introduced by IRDA and the guidelines for standardisation of definitions in health policies.

Various State Governments also have become major buyers of health insurance, covering mainly the BPL segment of the population, seeking to achieve the goal of universal health insurance. Apart from the Rashtrita Swasthya Bima Yojna (RSBY), the flagship scheme of the Ministry of Labour and Family Welfare, being implemented district-wise by several States, the governments of Tamil Nadu, Maharashtra, Odisha, Punjab and Goa have come out with various comprehensive health insurance schemes, aiming to cover specified listed surgeries for BPL/APL beneficiaries.

The public sector insurance companies are the dominant players in the health insurance business, accounting for approximately Rs 0.9 million in 2012-13, which is 60 per cent of the health business of the industry.

National Insurance’s Health Insurance Portfolio

National Insurance’s (NIC) aim is to become a leader in health insurance sector of the country by ensuring building up of competitive strength, growth of business, customer satisfaction and meeting social obligations while complying with all statutory and regulatory norms including solvency margin.

Over the years, National Insurance has been a significant player in health insurance. With a premium of Rs 0.25 million in 2012-13, its market share was 16.66 per cent in 2012-13. The growth and performance of health business during the last five years has been fairly consistent. National Insurance has maintained a steady growth rate of over 20 per cent during the last five years and is confident about sustaining this trend in future as well. Around 40 per cent of its health premium is from retail policies and the rest from various Group policies and Government and Mass Health Policies. There are quite a few micro health products as well.

The unique ‘Insurance on Wheels’ Project has added a new dimension by taking the general insurance services to the doorstep, thus making them popular channels for direct selling of health policies. The online portal affords convenience to the tech-savvy, who receive their policies within the comfort of their homes.

National Insurance’s aim is to become a leader in health insurance sector of the country by ensuring building up of competitive strength, growth of business, customer satisfaction and meeting social obligations

National Mediclaim Policy:

It has been Nayional Insurance’s constant endeavour to offer the best health insurance cover at a reasonable rate of premium. Keeping this in view, it has introduced a new and improved mediclaim policy for the individuals and their family members. The policy has become an instant hit because of the following important features:

• The policy can be renewed annually over life time. No denial of renewals.
• In addition to cover for allopathic treatment, the policy covers Ayurveda and Homeopathy treatment as well.
• As many as 140+ day-care procedures have been included and list appended to the policy for easy reference.
• Reimbursement of ambulance charges up to 1 per cent of the sum insured, subject to a limit of Rs 2,000.
• Ten per cent discount in the total premium is allowed if policy is bought for family.
• Assured good health incentives in the form of cumulative bonus @5 per cent of sum insured every year, subject to a maximum accumulation of 50 per cent.
• For better understanding, standard list of excluded items has been appended to the policy.
• Provision of grace period of 30 days in the policy will allow renewal, without loss of continuity benefits such as waiting period and coverage of pre-existing disease.
• The insured can avail tax benefits for the premium paid under Sec 80D of Income Tax Act 1961.
• Introduction of portability has made it easier to carry-over the policy without loss of continuity benefits.
• A newly introduced Free Look Period enables the policyholder to return the policy within 15 days of receipt if the terms and conditions are not acceptable, and get a refund in premium. Conditions apply.
• Claim procedure has been simplified and detailed in the policy.
• To facilitate redressal of grievances, addresses of touch points for lodging grievances has been provided in the policy.
• Cashless hospitalisation is available through TPAs in over 6,000 network providers across 1,500 cities/ towns/ centres.
• Package rates for select procedures are available in Preferred Provider Network (PPN) hospitals in select cities.
• Reimbursement of hospitalisation expenses is allowed for treatment taken in any hospital.
• The policy can be purchased and renewed online through the website or offline from National Insurance’s various offices.

Taking a lead in government schemes

One important segment of the health insurance portfolio is the Government and mass health insurance policies like Rashtriya Swasthya Bima Yojana, State-specific schemes like Rajeev Gandhi Jeevandayee Arogya Yojana in Maharashtra, Bhagat Puran Singh Sehat Bima Yojana in Punjab, Biju Krushak Kalyan Yojana in Odisha, etc. Today, NIC is implementing these schemes in 151 districts of the country.

NIC is also the pioneer in providing tailor-made Group Mediclaim policies specifically suited to the needs of individual corporates and groups, which have been received very well.

Steady growth of NIC’s Health portfolio over the years is a testimony to the popularity of its various health insurance products. That, combined with the trust and loyalty of our customers, encourages NIC to aspire for tripling its health insurance portfolio in the next five years.