Bajaj Allianz General Insurance has outbid Oriental Insurance Company to win the mandate for Gujarat and Reliance General Insurance has pushed out National Insurance Company(NIC) for Meghalaya in competitive bidding
Reliance General Insurance will be earning a premium of around Rs 150 crores that will the company to help bridge the gap in health portfolio that it has with peers
Mumbai/ Ahmedabad/Kolkata:
Two private sector general insurers have outbid PSU general insurers to bag Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)-accounts of Gujarat and Meghalaya for the next three years.
PM-JAY is fully funded by the government and cost of implementation is shared between the central and state governments.
Bajaj Allianz General Insurance has outbid Oriental Insurance Company(OIC) to win the mandate for Gujarat and Reliance General Insurance(RGI) has pushed out National Insurance Company(NIC) for Meghalaya in the competitive bidding.
However, NIC has managed to retain Jharkand for the next years on the basis of its efficient management of the scheme during the last three years.
RGI will be earning a premium of around Rs 150 crores that will the company to help bridge the gap in health portfolio that it has with peers.
The state of Meghalya had decided to review the Health Benefits Package and other terms in the Insurance Contract of MHIS 6 and has now decided to implement a revised MHIS 6 scheme in convergence with PMJAY, providing an insurance cover of Rs 5,30,000 for all eligible beneficiaries on a family floater basis. This contract will cover over 7 lakh families in Meghalaya, providing them with comprehensive health insurance coverage that will meet their secondary and tertiary care hospitalization, outpatient care, diagnostic tests, and follow-up care.
Rakesh Jain, CEO of Reliance General Insurance, said, “We will be partnering with the government of Meghalaya in this initiative of providing universal health coverage to the citizens of the state under the Megha Health Insurance Scheme and Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY)-Phase 6. We firmly believe that with the help of this contract, we will be supporting the state in bridging the much-needed gap of quality healthcare within the region, while increasing health insurance awareness and strengthening our foothold in the Northeast region.”
A few states, which had involved general insurers to run their (AB-PMJAY) for the last three years, are now putting the scheme for rebidding after tenure of the existing insurers are completed.
Since the launch of the AB-PMJAY in September 2018, states have been given the flexibility to adopt Trust, Insurance or a combination of both, termed the Hybrid mode of implementation. The Trust mode indicates that a government-registered trust, also termed the State Health Authority (SHA), purchases services directly from empanelled providers.
A lot of states like Uttar Pradesh, the largest state in the country, Haryana and Himachal Pradesh had opted for Trust model while states like Jammu & Kashmir, Punjab and Meghalaya had adopted Insurance model.
Ayushman Bharat PM-JAY is the largest health assurance scheme in the world which aims at providing a health cover of Rs. 5 lakhs per family per year for secondary and tertiary care hospitalization to over 12 crores poor and vulnerable families (approximately 55 crore beneficiaries) that form the bottom 40 per cent of the Indian population.