Private insurers stay away from religious group-based covers

About three years ago, a special family health insurance policy was introduced for the Jain community by Jain International Organisation. Treated like a group insurance scheme, now private insurers are not too keen to be a part of this.

Under this plan called Shravak Arogyam, individual could purchase an insurance plan for Rs 2 lakh under mediclaim. Also, there was a Rs 10-lakh personal accident policy for an earning member and Rs 5 lakh for a non-earning member for personal accidents.

For families, an insurance plan for Rs 5 lakh against mediclaim for self, spouse and two dependent children up to 25 years of age was also available.

"We have been receiving claims while premiums have remained low. This may not be sustainable on a long term basis," said a senior official of an insurance company associated with this scheme in the past.

From the first year itself, a large part of the community applied for this scheme. To be eligible, an individual needed to produce a religion certificate and the word 'Jain' was required to be mentioned in the school leaving certificate.

If it is a health cover for individuals, the yearly premium has been set at Rs 3320 for an individual below 40 years. For a family floater, unlike regular health products, maternity benefit, psychiatric treatment a nd stem cell transplant is also covered.

Insurance companies use the concept of anti-selection to ensure that a group consists of a mix of people so that other group does not end up compensating for one risky group.

For instance, a group with maximum members above 60 years may be a risky pool with health complications that would lead to claims being regularly paid out of the insurance prenium pool collected from all individuals across the country.

"There is a need to regularly revise the premiums especially since health check-ups are not required. Othewise, it could impact our books since religion-based covers are not exactly similar to a regular group policy," a senior insurance official said.

Currently, large-scale covers for any religious community are not offered by insurance companies though individual churches and gurudwaras do take some member-based personal accident covers.