NEW DELHI:
To promote the use of Artificial Intelligence*(AI) in the sector,TL Alamelu,member, Non-Life, IRDAI, on Wednesday said, IRDAI is planning to come out with a regulatory sandbox for fintechs and insurance companies for bringing innovation through the use of blockchain, AI which can be further broad based with suggestions.
Addressing a webinar 'Virtual Health Insurance Conference 2020-Innovation for Bridging the Gap', organized by FICCI, Alamelu said,in the next few weeks, she added that IRDAI will also be announcing the next tranche of insurance products under the sandbox regime.
Alamelu said that the next phase of innovation in health insurance would come from areas like artificial intelligence and health insurers should focus on developing disease specific policies to cover a larger population rather than focusing only on healthy individuals.
Alamelu, stressed upon the need for increasing the health insurance market in the country.
Alamelu said that as of August 14, the domestic general insurers have been able to sell a total of 7,50,000 Corona Kavach policies covering 1.28 million lives and have earned a premium of Rs 215 crore.
"Corona Kavach is popular and we have noticed that most of the policyholders have opted for the 9.5 month cover duration," she added.
Under the Corona Rakshak policy,that is a benefit-based health plan, the life insurers were able to sell 1,83,000 policies covering 2,17,000 lives and collected premium of Rs 29 crore.However, when it comes to Arogya Sanjeevani which is a standard health plan launched in April 2020, Alamelu said that policy sales have been muted. So far, she said 72,000 policies worth Rs 33 crore premium have been sold under Arogya Sanjeevani.
She urged the health insurance companies to focus on launching disease specific policies to increase the customer base.Alamelu further added that there is a need to set up a mechanism that the person with insurance policy gets benefits even at the diagnostic centre and pharmacy.
Highlighting the impact of COVID-19 spreading to tier 2,3 cities and rural areas,Alamelu said that there is an increase in the health protection gap in the health insurance sector.
"We have almost 96 percent people who have not claimed any health insurance under COVID-19.During this time also a small out of pocket expense in hospitals can financially impact the customer. There is a need to reduce this gap," she said.adding that having a minimal health insurance cover with exclusions is atleast better than having no medical cover,
If you take into account the 2.77 million Indians affected by COVID-19 and 1,25,000 health claims filed, this shows that only 4.5 percent of these individuals are covered.
Elaborating on the growth witnessed in the health insurance sector, she said that the current growth witnessed in the health insurance sector is on a fast forward stage. However, there is a rise in awareness as far as health insurance is concerned. Alamelu explained that there have been 131 new health products between March and now.
"The industry had a constant 500 number as far as health insurance is concerned, for close to two decades. Now after the lockdown, IRDAI has approved 131 new products. We are also at a fast-forward stage," she said.
"Today, health has become the biggest line of business under the general insurance category and by the year end, it will overtake motor insurance also," she added.Alamelu also emphasized the need for a better grievance redressal system to gain customers trust. "During this time, the number of grievances related to COVID polices are very less and resolutions are also positive by the companies. Health insurance companies should extend this mechanism to all other types of health insurance policies as well. This is the only way, trust can be built among the public," she added.
Ritesh Kumar,MD & CEO,HDFC Ergo General Insurance said that the industry has risen to the occasion to alleviate the pain of its policyholder impacted by COVID-19 to ensure coverage and faster turnaround time for claims approval, especially cashless.
Prasun Sikdar, MD & CEO, Manipal Cigna Health Insurance mentioned that today health insurance is no longer a 'priority' but a 'necessity' for people. He talked about making health insurance affordable, predictable and simple in order to bridge the gap between customer expectations and experience.
Mayank Bathwal, CEO Aditya Birla Health Insurance said that OPD expenses, contributing to more than 60% of healthcare spend and important for driving preventive care are still largely not covered under the insurance policies. With the advent of digital health and significant government and regulatory interventions like the NDHB & guidelines for tele-medicine, epharmacy etc. this is the right opportunity to enhance the scope of health insurance benefits to cover OPD expenses.
“Health Insurance Consumer Pulse Survey'' prepared by PwC and FICCI has said thatn India’s private health insurance sector has been experiencing high growth owing to more comprehensive and customised health coverage.It has registered a compound annual growth rate (CAGR) of 23% in the past 10 years and has become the fastest growing segment in the non-life insurance sector, with a market share of 24%.
It has also attracted huge investments in recent years, including foreign direct investment (FDI), with the share of FDI reaching 36% in 2018.
“Yet, health insurance remains an untapped market,with retail health insurance covering only about 3.1% of the Indian population.The National Health Profile 20192
states that around 48 crore individuals were covered under some kind of health insurance in 2017–18, which includes government and social health insurance schemes.'' said the survey..
Hence, there is huge potential for growth and penetration of health insurance in the country.
While the mounting disease burden, increasing geriatric population and rise in informed and empowered consumers will lead to expansion of health insurance coverage in the coming years, thesector, like most other service sectors, is likely to be shaped by future consumer expectations. This poses a huge challenge for any industry.
However,understanding the expectations of the health insurance consumer is a greater challenge,said the survey.
A total of 1.8 crore new health claims were registered during FY19. In terms of mode of settlement, 54% of the total number of claims were settled through the cashless mode and another 42% were settled through the reimbursement mode..