Senior care, lifestyle diseases may now get wider insurance coverage as norms change

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India will soon see a number of innovative and custom-made health insurance policies. They could range from home care to senior care to customised plans and insurance for several chronic non-communicable diseases (NCDs) like diabetes and hypertension.

Industry insiders say that patients of chronic diseases such as blood pressure, diabetes and kidney diseases—which are mostly not offered coverage under regular plans—could also have an option now.

If someone, for example, has hypertension for the last 10 years, a policy can be customised according to the person’s need and the premium amount can be fixed accordingly.

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“There can also be a policy soon for patients with heart disease covering procedures such as angioplasty,” said a senior executive associated with an online insurance aggregator.

What has opened the gates is the Insurance Regulatory and Development Authority of India’s (IRDAI) move to allow companies to launch most general insurance products, including health cover, without its approval.

This is particularly important in a country where voluntary private health insurance coverage is less than 20 percent of the population.

Though 50 percent of the country’s population or nearly 70 crore people are covered under the Centre’ flagship health insurance scheme, Pradhan Mantri Jan Aarogya Yojana, and group insurance schemes by states, about 30 percent of the population does not have any coverage at all.

Recently, the IRDAI announced to extend its ‘Use and File’ procedure for all health insurance products and almost all general insurance products.

This, the regulator said in a statement, is in line with the reforms agenda being taken up for having a fully insured India.

‘Will allow innovation’

Mayank Bathwal, CEO, Aditya Birla Health Insurance, and insurance forum leader at NATHEALTH, a network of private healthcare providers in India, said that the IRDAI move will allow the private sector to innovate.

“Insurers can now introduce many products that will help expand universal health coverage and substantially increase insurance penetration across the country,” he added.

While the regulator had allowed 'Use and File' procedure for group products some time back, the current circular about allowing the same feature for retail products would have a remarkably higher impact, noted Bhabatosh Mishra, director, underwriting, products and claims, Niva Bupa Health Insurance.

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New areas to be covered

Bathwal suggested that the ease in norms comes as an opportunity for insurers to cater to patients suffering from NCDs.

India is often called the diabetes and hypertension capital of the world as these NCDs affect a large chunk of the population. However, most health insurance companies do not cover people suffering from NCDs easily.

Things could change now.

“The change in rules has also opened doors for insurance companies to cater to the increasing demand of home care, senior care and other emerging care continuum models in the sector,” said Bathwal.

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Mishra said that after the reform, insurers can now launch highly innovative products fairly quickly.

“This also helps insurers to react swiftly to emerging trends and demands from customers.”

The pricing of these policies may, however, be higher than the regular ones as the risk of hospitalisation in the case of patients with chronic diseases is higher.

“However, we are hoping that these policies will still be lucrative for people and there would be higher demand and consumption of health insurance plans,” said the executive, associated with an online insurance aggregator quoted above.

‘Ease the entry of customised products’

Indraneel Chatterjee, co-founder of the insurtech firm RenewBuy, said that the amendment to the norms will provide the platform for the go-to-market strategy for insurers, where they can create customised products and cater to consumers, without much ado.

Customised products will help cater to the dynamic needs of markets, across cities, especially smaller towns and cities.

There are approximately 700 million people in the country who need insurance but cannot buy due to lack of accessibility, or lack of the right kind of insurance product, said Chatterjee.