New Family Health Insurance Policy By Oriental Insurance

Country's second largest public sector general insurer Oriental Insurance Company has launched a comprehensive health cover for family.

The Oriental Insurance Company Chairman cum Managing Director M Ramadoss said,”Happy Family Floaters Policy aspires to protect one and all against escalating medical costs in turn creating healthy tomorrow for Indians.”
The happy family floaters policy will be available in two options gold and silver plan, the sum insured varies in between Rs 1-10 lakh, he added

From this unique product that the company has launched, he said the company "expects to earn premium of Rs 100 crore in the remaining months of the current fiscal".

Elaborating on the features of the product, Ramadoss said it provides extensive cover for medical expenses of illnesses and accidents requiring in-patient hospitalisation.

He said that optional covers are available for personal accidents worldwide, besides an add-on benefit of life hardship survival for certain critical diseases.

The policyholder can avail tax deduction up to Rs 15,000 and Rs 20,000 for senior citizens. At the same time, no medical check-up is required for insured age up to 60 years, he said.

The policy cover can be renewed till the holder reaches 65 years of age, with no limit on the age of dependents, he added.

Pillion rider's death are not entitled to third party insurance claims- SC

The Supreme Court has ruled that relatives of a pillion rider or other gratuitous passengers in a vehicle involved in road accidents are not entitled to third party insurance claims.

In this case, the victim Ramulu was riding pillion in a scooter belonging to Yadi Reddy in Hyderabad city on October 8, 1996. The vehicle at that time was being driven by Mohd Yasin.

Ramulu's widow, son and father filed a claim petition for compensation of Rs three lakh, but the Motor Accidents Claims Tribunal rejected the plea on the reasoning that the pillion rider's claimants were not entitled to any claim as the insurance policy only covered third parties.

However, the Andhra Pradesh High Court on an appeal took a contrary view and directed the United Insurance Company to pay the compensation following which the insurer filed an appeal in the apex court.

Upholding the insurance company's appeal, the apex court citing its earlier ruling in the Asha Rani and a number of other cases said a pillion rider or other gratuitous passengers traveling in a goods vehicle are not covered under third party insurance claims.

As such the claimants in the present case are not entitled to compensation, the apex court bench of Arijit Pasayat and Mukundakam Sharma observed.

Health identity card, insurance for women

Health identity cards will be given to members of all Stree Sakthi Sanghas in Hebbal by January 31 next year, according to IT-BT minister Katta Subramanya Naidu.

He asked women to take charge of responsible posts in organizations so that they can bring change in society. "Chinese women have brought rapid development in their country. Every Chinese woman is a productive member of their society. Our Stree Sakthi groups have the potential to bring a similar change in India," he explained.

The Minister called upon the stree sakthi groups to take up small and medium enterprises to generate income to build the sanghas and generate small income to support their families. Stree Sakhti groups should work towards building small enterprises from their micro-credit units to fund themselves instead of always looking for loans from external sources if they have to become successful.

Several small scale industries owners such as packaging, photoframes,stationary who were present at the conference spoke and expressed their willingness to train women, provide raw material and buy back end product from them.

He furtehr added that in Hebbal Assembly constituency, Rs 50 crore was earmarked for road development and road widening and over 45 borewells had been dug over the last four months.

Munirathnam Naidu, Assistant Commissioner of Police of the area, announced that women from the sanghas would be taken as Community Police (at the rate of 5 women for every police station in the area) and would assist the police in their activities in the area.

Indemnity health insurance: Benefits & Drawbacks

An indemnity insurance plan is quite commonly recognized as a traditional health insurance or mediclaim policy. Although it is quite expensive to have this kind of health insurance, it does cover many illnesses that are often not included in other insurance plans. Make sure to understand about the advantages and drawbacks to this kind of insurance plan before you opt for it.


Benefits:

• The patient is allowed to consult the physician of their own choice and not be restricted insurers choice of hospital or physician
• Insured person can opt to consult a specialist without going through a primary care physician.

Drawbacks:

• The premiums you need to pay in this plan might be more
• You would have to bear some upfront expenses and to put in all the paperwork for claims.

But, it is essential to keep an open mind and not just look at the drawbacks as there are several important pluses to this kind of health insurance.

Kerala launches a insurance plan 'Total health for all'

Aiming at total health for all and providing a “cash less” treatment, the State Government would launch a health insurance scheme on October 2 benefiting both the BPL and APL categories.

The Labour Minister P K Gurudasan told reporters that the Centrally sponsored Rashtriya Swasthya Bhima Yojana (RSBY) covering the entire below poverty line category and the state sponsored Comprehensive Health Insurance Scheme (CHIS), covering the entire non-RSBY population will be launched in all the 14 districts in the first phase itself.

The schemes would cover all the BPL families and also other deserving families. The RSBY ensures maximum amount of Rs 30,000 for a family of five and the treatment can be availed of from the empanelled government, ESI and private hospitals based on package rates, he said.

The non-RSBY population will be divided in two categories - those belonging to the BPL list of the government but not to the list defined by the Central Planning Commission - and the APL families that belong neither to the government list nor to the list prepared as per the guidelines of Planning Commission.

The beneficiary contribution will be Rs 30 per family per annum for RSBY and families belonging to the first category in the CHIS.

With regard to the latter, the contribution will be paid by the government while APL families will make the payment themselves. The annual premium for the APL categories will be Rs 506.

The main attraction of the insurance scheme for the APL category is that there is no age limit for joining. About 780 medical and surgical interventions have been identified which will be covered under this scheme.

A committee has been constituted to fix the package rates of surgeries for which private hospitals will enter into an agreement with the insurance company, said Gurudasan.

A separate agency called Comprehensive Health Insurance Agency of Kerala has been created for the implementation of the scheme. A high-power supervisory council to monitor the scheme has been constituted with Labour and Health Ministers and secretaries from the departments concerned as its members.

AIG's India operations, banking system sound

The Indian operations of the US-based financial services giant American Insurance Group (AIG) are sound and so is the case with domestic banks, Finance Minister P. Chidambaram said in New Delhi on Thursday, against the backdrop of the current global financial crisis.

Addressing reporters after a cabinet meeting chaired by Prime Minister Manmohan Singh, the finance minister said while the government was closely watching the global financial markets, the Indian banking system remained strong.

He specifically spoke about AIG's life and non-life insurance businesses in India in a 26:74 ratio with the Tatas and said there was no cause for worry - an opinion shared by the Insurance Regulatory and Development Authority (IRDA).

“Don't compare AIG with Lehman Brothers,” Chidambaram said.

He was referring to the largest bankruptcy filing in the US history by Lehman Brothers, as opposed to funds sought by the AIG to remain afloat, which the US central bank agreed to with $85-billion bridge loan. For full story read AIG's India operations.....

Tier -2 cities to be TPAs target for health insurance growth

Touted as a vast untapped market for health insurance growth, the tier – cities have become a hot area for the TPAs. Third Party Administrators or TPAs as they are popularly called are organizations, which specialize in processing of insurance claims for various health insurance providers.

Around 10 – 15 branches comprise an average size branch network of a TPA in India. Most of the branches are located in metro cities or state capitals leaving a large uncovered area in rural areas and small towns. In contrast, the general insurance companies, which control nearly entire health insurance product, portfolio, are present in an average of 400 locations.

The government sponsored health insurance schemes like the Rashtriya Swasthya Bima Yojana (RSBY) have put a tremendous pressure on TPAs to deliver in the tier-2 cities and remote areas of the country.

MediaAssist, one of the major TPA players in the country has ambitious plans to expand into tier-2 cities. It is planning to increase the number of centers and the employed workforce to cater to the vast number of people covered by various government-sponsored health insurance schemes.

HDFC enters health insurance with critical care

Private sector life insurance major HDFC Standard Life, has decided to enter into health insurance market with its product – HDFC Critical Care.

This flagship product is expected to provide an insurance cover against 30 critical illnesses. A person can get himself covered for a minimum sum assured of Rs. 2 lakhs and a maximum sum assured of Rs 20-lakhs.

This health insurance product will provide a lump sum benefit payment irrespective of actual medical cost, flexible premium payment option and a benefit payable on survival for a period of 30 days post diagnosis of the critical illness..

The maximum term available for the cover is 20 years, while the minimum tenure is five years. The minimum and maximum age at entry is 18 and 55 years respectively.

The maximum age at expiry of the policy can be 65 years.

This critical illness policy comes with a unique feature, where if a person is diagnosed with a set of critical illness categorized as ‘Group B’, he/she can get a premium waiver option. Under such a situation, 50 per cent of the sum assured would be paid in case of a valid claim and post the claim all further premiums would be borne by HDFC Standard Life and the policy would continue, the release said.

Critical health insurance being the first such product, the company also plans to launch other health care products like surgical care and hospital cash in near future.

“Our entry into health insurance market is a significant move in line with our business objective. The low penetration of health insurance in India gives us a tremendous opportunity to provide quality health insurance,” HDFC Standard Life's Managing Director & CEO, Deepak Satwalekar, said.

Health Insurance: Max India & UK Based BUPA Tie up

Max India one of the leading private insurance-provider has joined hands with UK-based Bupa to set up a standalone health insurance company.

British United Provident Fund (Bupa) the JV partner will hold 26 per cent of the stake in the company which will be called as Max Bupa Health Insurance Ltd. Rest of the company will be held by Max.

Max India Chairman Mr Analjit Singh said, “The initial share capital of the JV will be Rs 100 crore and the business are expected to be up and running in 12-15 months. However, Bupa will have an option and right to go up to maximum amount of FDI allowed by the government in case FDI reforms take place.”

Max, an expert in health care facilities has a customer base of around 2.7 million and operates specialty hospitals around the country. According to the Chairman, the products will be rolled out in phased manner and region wise. “We are not in a hurry to launch (the joint venture) immediately. We want to have ground preparation first which will take at least 12-15 months,” he added.

Broad range of products like individual, retail and group insurance will be targeted by the joint venture and the company plans to cover one million individuals as its customer base.

“The country has a huge potential for health insurance as the average age is expected to be 29 years in the next 12 years with people getting more spending power,” said, Anuroop Singh, Director Max India.

Insurers see retail health plans as next big thing

Managed healthcare may still be a far cry, although health insurance premium has swelled to around Rs 5,000 crore.

Insurance biggies are now betting on big retail business in health, with the large private players coming up with new plans and innovative distribution channels to tap this promising segment.

With medical inflation estimated to be around 15-17%, the awareness needs to be built up urgently is the common refrain. The scope of the health care market is said to be around Rs 60,000 crore but the share of insurance is at present less than 1%.

Moreover, over 80% of the market is indemnity driven and is largely covered by mediclaim.

New business premium from health plans offered by life companies is still small at less than

Rs 100 crore and has a long way to go said life insurance officials. Out of the total premium garnered at present, retail is just about a share of 50% while the balance is from group plans.

Binay Agarwala, senior vice-president, health business and corporate strategy, ICICI Prudential Life, told DNA Money, “We feel that life companies have a huge retail presence, which will extend to health products as well. Health insurance is slightly different from pure life insurance. It is necessary to understand health insurance risks separately and price it.”

“We train our distribution forces differently as the pitch for health products is different from a life insurance product. Currently we have five core products and will look into variants in future.

It is a big challenge to create awareness and understanding of the need of health insurance products”, said Agarwala.

Some of the earlier life entrants into the health space are Tata AIG Life, ICICI Prudential and Bajaj Allianz, Reliance Life. Max New York Life, which, came up with a slew of health products, also proposes to tap the retail segment.

For Bajaj Allianz Life, health is one of its key verticals and the company expects to do Rs 120 crore of premium in the current year from the products that it has at present. It will be looking at various new products on women and children in the coming months.

Ujjaini Dasgupta, head, health insurance, Bajaj Allianz Life said, “Essentially standard mediclaim products are different from pure health plans with a life insurance element but with time and innovative products, customers will have a wide choice definitely”.

SBI Life Insurance CEO, U S Roy said, “There is a big segment and we propose to come in with innovative products in health”.

An Asian healthcare study by Credit Suisse that the private sector accounts for 80% of the healthcare expenditure with 64% being out of pocket and public health expenditure in India is among the lowest in the world at around 1% of the GDP.

Now insurance policies available in kirana shops

A small photo studio in T Nagar, Chennai, sold more than 50 general insurance policies in the last months alone. All that a person had to furnish was his name, address and the nominee’s name. The policy document will be issued in 15 minutes, shop owner M Raju Mani said.

With the general insurance penetration at a dismal 0.60 per cent (measured as a percentage of GDP), many companies feel that selling the policies through photo studios, grocery stores and even telephone booths would help improve the figure.

“We need to think outside the box and need alternative channels. If telecom companies are able to use grocery stores, petty shops and other small outlets, why not insurance companies?” said an Irda official.

The Committee on Distribution Channels, headed by LIC ex-chairman N M Govardhan, in its report recommended that one of the biggest challenges for the general insurance companies was getting agents to sell their products. The report noted that people are not interested in becoming general insurance agents as the commission is quite low.

In 2005-06, around 40,551 agents were licensed by the general insurance companies compared to 7,21,696 agents employed by the life insurance companies. The committee was constituted by the Insurance Regulatory and Development Authority (Irda).

Private insurers have already gone ahead and started exploring such channels. Bajaj Allianz General Insurance Company has introduced point-of-sale concept on a pilot basis to sell its products.

The point-of-sale concept started in Delhi, where the company’s agent will go to the customers’ homes along with a handy gadget like a blackberry to issue policies on the spot, said Swaraj Krishnan, chief executive officer, Bajaj Allianz General Insurance Company.

The company is also talking to some medical pharmacy chains to sell its health and home insurance products. For motor insurance, the company is in talks with oil companies to sell its products through their retail outlets across the country, he added.

The gadget costs about Rs 50,000. The company wants to supply the gadgets to all its branches, but there is shortage of these machines since there are only two Korean suppliers.

Similarly, ICICI Lombard General Insurance sells its health and motor policies through photo studios and malls. The photo studio in Chennai is selling both the policies.

HIV Positive to get insurance policy

An insurance company, in a first of its kind initiative has brought an insurance policy, which will cover HIV positive patients. The illness caused by HIV due to the weak immune system of the patients will be covered under this policy.

This policy has been launched by Star Health and Allied Insurance Company, The policy will cover cover hospitalisation expenses incurred on opportunistic illness acquired by an HIV+ person.

Uday Chandran, VP Government & New Initiatives, Star Health & Allied Insurance Company said, "The policy is unique not only in India but also in the world. It will cover hospitalisation expenses as a result of opportunistic diseases acquired by the HIV+ person.”

“The policy would not cover any treatment cost for HIV like Anti Retro- Viral Therapy (ART) and would also not cover conditions, which existed before enrolling into the policy. It will only cover illness acquired by such persons due to weakness of their immune system,” he added.

TB & gastroenteritis, two most common diseases affecting HIV positive patients will also not be covered under this policy. Stating the reason for this exclusion Chandran said that the company wanted to keep the policy as cost effective as possible.

On asked if the policy would take care of expenses once a HIV+ person is declared full blown AIDS patient, he said that in such cases, lump-sum amount is paid to the policy holder as per the sum insured by him or her.

Now, insurers can`t refuse health cover renewal

In a move that will bring cheer to health insurance policyholders, non-life insurers are finalising the contours of a new product that will have a common minimum standard cover and will be renewable and portable across companies.

The move being pushed by the General Insurance Council, the self-regulatory body, will mean that insurers cannot refuse renewal of policies on grounds of adverse claims. Similarly, all benefits will continue to be available to an insured person even if he or she switches to a new company.

While pre-existing diseases are only covered after four years of a policy, an insured will be eligible to these benefits from the first year of switching to a new company. In addition, cumulative bonus and discounts will also be available after the change.

General Insurance Council Secretary General K N Bhandari said those buying a health cover at an early age will not be denied renewal on grounds of adverse claims. So, if someone buys the new cover at, say, 30, he will still get a cover at 50 years even if the he has developed heart problems and has filed for claims.

Insurers will approach the Insurance Regulatory and Development Authority for approval of the new product that will come with all these features later this month. Premium is, however, yet to be finalised, but will be affordable, Bhandari said.

“Insurance companies will not refuse renewing the health insurance policy except on specified grounds such as moral hazards. In case the insured has cheated the insurer or not disclosed the full facts regarding his health or in those cases where there is no correct exposure, we will refuse renewing the cover,” he added.

Health insurance policies contain the renewability clause that specifies the type of the contract and terms for renewal, which are of three types. The first type is optionally renewable, where the insurer has the option to renew the policy on its terms. This is the cheapest policy for the insured.

The second type is guaranteed renewability, the premium rating for which depends on the claims experience. The third type, which is the most expensive variant, cannot be cancelled and renewal is guaranteed, but the price can vary.