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Health insurance is an industry which is forever abuzz. New product launches, regulations being passed, plans being withdrawn, etc. are just some of the many events which have the potential to affect hundreds of policyholders. Stay up to date on all happenings in the health insurance sphere with the latest news which we have curated for you.
As per an announcement made by Max Bupa, the health insurer and MobiKwik have partnered in order to promote small group health insurance to the 107 million customers that MobiKwik has across India.
Bite-sized insurance policies are mainly targeted towards millennials and working professionals. Such insurance policies are gaining a lot of popularity in India because they are easy to buy and are available at a low price. The health insurance policy can be bought online, and claims can be filed online as well. Max Bupa will provide cancer cover at a nominal price along with HopiCash as well. The annual premium that must be paid is Rs.135, and Rs.500 per day will be provided by HopiCash as hospital allowance for a duration of 30 days in a year.
In case the customer is admitted to an Intensive Care Unit (ICU), the allowance will be doubled. Additional security is also provided in case of accidents. The policyholder’s family will get a compensation of Rs.1 lakh in case of accidental death. Max Bupa also provides compensation in case the customer is suffering from any vector-borne diseases such as malaria, chikungunya, dengue, etc. A lump sum amount of Rs.10,000 is provided under such circumstances.
2 July 2019
Max Bupa, one of the standalone health insurance companies in India, signed a bancassurance deal with IDBI Bank Ltd. The agreement was made on June 1 and it is the first time that IDBI Bank has been made the corporate agent for a SAHI partner. As part of the deal, Max Bupa will offer an array of health insurance products along with digital-first solutions that will be designed to be offered among the 20+ million customers of IDBI Bank through its 1,800+ branches in the country. Speaking about the deal, the MD and CEO of Max Bupa, Ashish Mehrotra, said that the customers of IDBI will benefit from the many health insurance products offered by the company.
IDBI Bank has plans to focus more on increasing the fee income gained through third-party distribution. The bancassurance partnership is hence a step towards this goal. The MD and CEO of IDBI Bank, Rakesh Sharma, stated that the firm made an alliance with Max Bupa due to the increase in demand for health insurance products by the bank’s customers. The insurance company will offer its services such as access to the Point of Care desks at major hospitals and pre-authorisation of cashless claims.
13 June 2019
According to a survey conducted recently, the percentage of women covered under health insurance is significantly low. On an average, women in the age group of 55 and above are the ones who make the highest number of claims but this age group has the lowest insurance coverage. Women in the age group of 26 years to 45 years are vulnerable to critical illnesses such as vaginal cancer, cervical cancer, and breast cancer. Only 60% of this age group holds health insurance.
Of the total number of women who have purchased health insurance for themselves, 75% of them have opted for maternity benefit. On taking individual health insurance policies into account it is found that 20% of them are purchased by women and 80% by men. This means that less than a quarter of working women in urban areas cover themselves under health insurance.
14 May 2019
The top think tank of the Central Government, Niti Aayog, said that close to 2,500 hospitals will be set up across the country in the next five years. The head of the Medical Council of India – Board of Governors and a member of Niti Aayog, Vinod Paul, said that new hospitals will be established in tier II and tier III cities. The Central Government had issued an advisory to state governments asking them to facilitate the setting up of private hospitals in underserved regions and small town. This decision was taken after the government realised that there aren’t sufficient hospitals to cater to the needs of the 10 crore vulnerable families covered under the health insurance scheme – Pradhan Mantri Jan Aarogya Yojana.
The statutory prepared by the Niti Aayog and sent across by the Union Ministry of Health and Family Welfare urged states to facilitate the opening of hospitals by way of seeing to it that land is easily available and that permissions and clearances are given within a specific time frame. The Centre has also asked states to sanction loans at agricultural rates and provide electricity at residential rates. The Centre is asking states to take all measures that will make it easy for private entities to set up and run hospitals in such regions.
13 May 2019
Bajaj Allianz General Insurance, in collaboration with Bajaj Allianz Life, has introduced a new product named Total Health Secure Goal. The plan will take care of both, life and health, needs of insured individuals. This will get rid of the need to maintain separate insurance policies. The product has been formed on combining the features of the Health Guard policy by Bajaj Allianz General and iSecure by Bajaj Allianz Life. The plan can be availed from either of the companies and at a 5% discount.
The Health Guard policy comes with a Silver and a Gold option with sum insured amounts ranging from Rs.1.5 lakh to Rs.50 lakh. All hospitalisation and related expenses will be covered under the policy. The iSecure plan, on the other hand, offers term insurance coverage at an affordable price. The plan offers a joint life option that offers coverage for the spouse as well. Special premium rates are offered for high sum assured amount as well as non-smokers.
3 May 2019
Non-Life Insurance Companies saw their gross direct premium grow by 13% for the FY2019-20. The companies reported a collection of Rs.1.70 lakh crore. According to the market participants, the insurance industry did well thanks to the surge in health insurance and crop insurance. From the list of 25 general insurance companies, only United India Insurance and National Insurance experienced a negative growth.
New India Assurance showed that it is the biggest player in the health insurance sector as it held 14.06% of the total market share while ICICI Lombard was on top in the list of top private health insurance company by holding 8.52% of the total market share. There were four public sector insurance companies who held a collective market share of 40% as compared to 45% for the previous year.
26 April 2019
Along with I Prospect India, General Insurers Royal Sundaram have launched a new ad campaign called ‘the Unusual Gift’. According to the makers of the ad campaign, the idea behind the ad campaign was to show love to one’s close ones in an unconventional way of gifting them health insurance, which symbolises love and care. According to the vice president of iProspect, the ad campaign persuades loved ones to gift their special one health insurance, and the backdrop of the campaign is to break away of the stereotype of gifts in a box. The retail head of Royal Sundaram commented by saying that the insurer has a policyholder base of 5 million customers, and they wish to reach more customers through digital platforms and the unconventional ad campaign is the right way to start tapping the digital market.
15 April 2019
The Insurance Regulatory and Development Authority of India (IRDAI) has asked all insurance companies to share the status of claims with the insured individuals every step of the way. The new regulation will come into effect starting from July 1. The circular issued by the insurance regulator stated that it is important to ensure a fair and transparent claim procedure. In case of health insurance policies, since third-party administrators are involved, insurers should ensure they share the claim status with the policyholder.
The IRDAI further said that all insurance companies involved in life insurance, health insurance, as well as general insurance should send all communication regarding policy issue and servicing through hard copy, SMS, e-mail, or any other electronic mode approved by the IRDAI. Also, companies will be required to send regular intimations cautioning policyholders from spurious calls, or offers. The language in which the message is sent should be easy to comprehend. Also, the communication should be carried out in the regional language apart from English/Hindi.
12 April 2019
Aditya Birla Health Insurance Company has collaborated with India’s leading choreographer Remo D’Souza to promote their latest health campaign #JumpForHealth on the World Health Day which is celebrated on 7 April 2019.
#JumpForHealth is a month-long campaign which aims to help people take the journey of being healthy by jumping and help the physically disabled people walk again. As per the campaign, there will be one prosthetic leg donated to the underprivileged for every 1000 jumps. In the past two years, the insurer has recorded 7.7 million jumps and has donated 770 prosthetic legs.
Remo D’Souza with whom the insurer has collaborated will create a #JumpForHealth themed dance video and will subsequently nominate others to promote the campaign.
11 April 2019
Considering that insurance policies offer coverage to the dependents of the policyholder in the worst of situations and offers financial sustenance, the Insurance Regulatory and Development Authority of India (IRDAI) is considering paying the claim settlement in installments, especially in the case of personal accident claims in the case of death or disability. According to the IRDAI, the installment option will ensure that the dependents of the policyholder will receive a regular income for a period which will be beneficial in the long run as supposed to the lump sum payout option. The IRDAI is currently drafting out the guidelines of the installment option for claim settlements and have said that the stakeholders will have a say on whether this passed. The IRDAI said that the installment option will be for a maximum of 5 years depending on the claim period and that the installment option will grant the dependents of the policyholder more money that with the lump sum option, taking into consideration the TDS (Tax deducted from source). The stakeholders will comment on IRDAI proposal on 17 April 2019.
9 April 2019
Aditya Birla Health Insurance is a prominent health insurance company that was established in the year 2016 and aims to break even by FY 2022-23. Insurance companies are said to take about six to seven years to break even. Therefore, the CEO of the company, Mayank Bathwal, believes that the company is on track. The firm is a partnership between Aditya Birla Holdings and a financial services company, MMI Holdings. Bathwal said that the company wishes to become a health partner or a health influencer more than a health insurer.
During the first three quarters of the fiscal year, Aditya Birla Health Insurance witnessed a growth of gross written premium at Rs.316 crore, which is an 83% increase from the year-ago period. The company has bancassurance partnerships with various banks like HDFC Bank, Deutsche Bank, KVB, AU Bank, etc. The company has adopted a multi-channel distribution plan.
14 March 2019
The co-founder of Microsoft, Bill Gates, appreciated the healthcare scheme launched by the Modi-led government for its success in the first 100 days. Prime Minister Modi replied to the tweet and stated that the government’s commitment to serve the people and provide affordable health coverage led to the success of the scheme. He further added that a large number of people have already benefitted from the scheme and a lot more will benefit from it in the future.
Ayushman Bharat, renamed Pradhan Mantri Jan Arogya Yojana, was launched in September 2018 and has benefitted 6.85 lakh beneficiaries in the first 100 days. As per the scheme, each economically backward family will be provided with a health cover for Rs.5 lakh to take care of secondary and tertiary medical expenses. Though a majority of the states have accepted to implement the scheme in their respective states, some of the states have asked for alterations in the functioning of the scheme or rejected the scheme altogether. The scheme was launched with the idea that 60% of the expenses will be taken care of by the centre and 40% will be contributed by the state government.
18 January 2019
With health insurance in the country getting its biggest boost ever with the launch of the Ayushman Bharat scheme by the Government of India, also known as the ModiCare as labelled by the media, Health Insurers Apollo Munich has rolled out a new health insurance plan that will specifically cater to diabetes patients in the country. The plan was rolled out on the world diabetes day and comes with features such as no waiting period for the coverage, reward points for loyal customers, and 24/7 claims. Customers aged between 18 and 65 years who are suffering from Type I and Type II diabetes are eligible for this plan. The plan comes with a sum assured between Rs.2 lakh and Rs.50 lakh and customers can choose between either Gold Plan or the Silver Plan. The plan covers pre-hospitalisation expenses, in-patient hospitalisation expenses, post-hospitalisation expenses, and coverage for ambulance along with free wellness programs. Customers opting for this plan have the privilege of the free-look period, with which they can return the policy for no cost at all within 15 days if they feel that the plan does not suit their needs.
15 November 2018
In order to make the coverage offered by health insurance policies more customer-centric, a panel created by the Insurance Regulatory and Development Authority of India (IRDAI) has proposed certain changes.
The changes proposed are with regard to the waiting period of health insurance policies, the inclusion of various conditions that were previously excluded from coverage, inclusion of certain advanced medical treatments, and mandatory coverage for ailments or diseases that the policyholder develops after purchasing the policy among other things.
In its report, the insurance regulator specified that the premiums collected for health insurance policies has increased significantly during the past few years. The premium collected for health insurance covers in 2017-18 was Rs.37,000 crore, in comparison to a premium collection of Rs.741 crore in 2001-02. The report mentions that the health insurance industry in India is expected to grow at a 24-25% rate for the next 5-6 years.
15 November 2018
Around 77,000 families which consist of 4.85 lakh people are eligible to receive benefits from the Ayushman Bharat - Pradhan Mantri Jan Arogya Yojana (AB -PMJAY).
An awareness campaign will be launched in order to let people know about the enrolment under this particular health scheme.
Around 146 Common Service Centres (CSC) will work to enroll people under this scheme across districts in Jammu and Kashmir. They will also receive help from BLO and Anganwadi workers in order to ensure that no entitled family is left out. Each CSC is supposed to enroll at least 20 families on a daily basis which equals 2,920 households.
14 November 2018
State-owned general insurance firm New India Assurance has reported a 56% decline in its net profit for the second quarter ended on September 2018 (July to September) owing to various catastrophic losses witnessed in India and abroad. For the second quarter, the company reported a net profit of Rs.328.64 crore compared to Rs.748.26 crore reported in the same period of last year.
The company announced its profitability in a regulatory filing. For the recently ended quarter, the total income of the insurer increased to Rs.6,237.29 crore compared to Rs.5,719.38 crore for the same period of last year.
Despite the significant decline in profit, the company’s Co-Chairman Hemant G Rokade stated that New India Assurance continues to be the market leader in the industry. It is currently the largest non-life insurance company in India with a 14.4% market share in the industry. Another notable fact is that the company currently operates in 28 countries.
14 November 2018
State-owned general insurance firm New India Assurance has reported a 56% decline in its net profit for the second quarter ended on September 2018 (July to September) owing to various catastrophic losses witnessed in India and abroad. For the second quarter, the company reported a net profit of Rs.328.64 crore compared to Rs.748.26 crore reported in the same period of last year.
The company announced its profitability in a regulatory filing. For the recently ended quarter, the total income of the insurer increased to Rs.6,237.29 crore compared to Rs.5,719.38 crore for the same period of last year.
Despite the significant decline in profit, the company’s Co-Chairman Hemant G Rokade stated that New India Assurance continues to be the market leader in the industry. It is currently the largest non-life insurance company in India with a 14.4% market share in the industry. Another notable fact is that the company currently operates in 28 countries.
14 November 2018
The Health Minister of the state of Haryana, Anil Vij, praised the efforts of the state government to create better healthcare facilities and provide advanced healthcare services to the people of Haryana. During his address on Saturday, he said that 13 civil hospitals, 26 primary healthcare centres and 14 community centres have been set up in the state in the past four years. He emphasised on the fact that the past few years have been highly beneficial for the people of the state in terms of the healthcare facilities that have been made available to them. A cancer treatment centre is being constructed in Ambala and motorcycle ambulances have been introduced in hilly regions such as Panchkula and Morni. The Ayushman Bharat health insurance scheme that was launched this year will offer coverage to more than 15.5 lakh families in about 22 districts of the state. Each family will be provided with a coverage amount equal to Rs.5 lakh per year. About 4.68 lakh construction workers who were identified in a recent survey will also be covered under the government-funded scheme. He also stated that BPL families in the state will have access to free medical check-ups too.
12 November 2018
A panel set up by the IRDAI has recommended a standard list of 17 pre-existing ailments/diseases that can be excluded from the coverage of health insurance policies. Also, the panel has recommended that diseases like Parkinson’s, Alzheimer’s, morbid obesity, and AIDS/HIV cannot be excluded from coverage if the policy buyer contracts the disease after purchasing the policy.
The standard list of pre-existing diseases that can be excluded are congenital heart disease, epilepsy, chronic liver, cerebral stroke, kidney diseases, Alzheimer’s hepatitis B, Parkinson’s, loss of hearing, HIV and AIDS, and physical disabilities.
Further, the working group has given the exact ICD code or classification to ensure a smoother claim settlement process for policyholders. The panel has also suggested that the current two-year waiting period for ailments should be increased to four years. However, it has also recommended that the waiting period for conditions like cardiac problems, hypertension, and diabetes should be reduced to 30 days.
The report also suggests that insurance companies can include permanent exclusions into a policy with the consent of the customer to enable even people with serious medical conditions can get health coverage.
10 November 2018
Chola MS General Insurance and IndusInd Bank have had a bancassurance partnership for quite some time now. According to a press release, Chola extended the partnership for another 5 years. This is the third consecutive time the corporate agency agreement has been renewed. The partnership provided services to half a million people during the previous year alone, and created about Rs.3,700 crore in the past five years. IndusInd Bank is the corporate agent of Chola Insurance and has played an active part in distributing the many insurance products offered by the insurer. The ten-year-long partnership has certainly benefitted the two partners. Chola MS believes that IndusInd is a valued partner and will help continue the insurance business by offering the many policies that offer maximum protection at minimum costs. Chola MS is all set to introduce digital insurance solutions for its customers to make the insurance process simple and quick. IndusInd’s business is spread out throughout the country and believes in the digital drive and financial inclusion of all citizens in urban as well as rural areas. Chola’s digital initiative will hence be in line with the objective of the company.
5 November 2018
The Primer Minister’s office recently convened to review a proposal to provide universal social security to around 50 crore workers in India. As part of this scheme, the government will be extending health insurance, maternity, pension, provident fund, and other benefits to enrolled individuals. Currently, a total of 10 crore workers are offered these benefits. The Labour Ministry of India has proposed to implement this scheme over a period of 10 years in three phases.
In the first phase, which will a cost a total of Rs.18,500 crore, all 50 crore works will get retirement and health security benefits. Unemployment benefits will be offered as part of the second phase, while welfare measures will be added in the third phase.
The beneficiaries of this scheme will be classified into four tiers. The first tier will comprise of individuals who are below the poverty line. The government will bear the entire cost for all individuals enrolled under the first tier. Individuals employed in unorganised sectors may be enrolled under subsidised schemes as part of the second tier. The third tier will include individuals who by themselves or along with their employers can make the necessary contribution. The fourth tier will include relatively affluent individuals who can make provisions for themselves for meeting risks or contingencies.
2 November 2018
The government is planning to set up a cadre of central services in order to manage social security schemes as it looks to overhaul the function and structure of the Employees Provident Fund Organisation (EPFO).
The government may hire officers and send them on deputation to take care of state social security boards that have already been proposed to set up under labour code on social security.
As per the proposal, all the Grade A officers under EPFO and ESIC will be merged together into the Social Security Service.
The cadre will help in taking care of lakh crore of social security corpus as the government plans to make it universal following a decentralised approach for all its workers.
According to a proposal made by the labour ministry, it is suggested that independent bodies must be set up by states so that they can take on executive duties at EPFO.
1 November 2018
Standalone health insurer Religare Health Insurance has launched an awareness campaign titled ‘Don’t Eat the News’ to educate people about the harmful effect of eating food items wrapped in newspapers. This campaign has been created by the insurer after the Food Safety and Standards Authority of India (FSSAI) issued a warning about the consumption of food wrapped in newspapers.
The campaign document released by the insurer noted that the printing ink used in newspapers contains various chemicals like pigments, dyes, alcohol, and preservatives. These chemicals could cause various digestive issues to people and may also result in various health ailments like food poisoning, kidney ailments, high blood pressure, etc. In certain cases, this may also lead to cancer. This largely affects the children and the elderly who have a weak immune system.
As a part of the campaign, Religare is distributing paper wraps that are printed in edible ink to street vendors in the country. The company has also launched a helpline to address any queries related to this issue.
31 October 2018
The acquisition of Star Health and Allied Insurance by Safecrop Holdings is expected to be completed by the next fiscal year. The company has noted that there is not likely to be any re-branding once the acquisition is over. The acquisition has also received approval from the Competition Commission of India earlier this month.
Other terms of the acquisitions are currently being discussed right now. Safecrop Holdings is a consortium of companies comprising billionaire investor Rakesh Jhunjhunwala, Westbridge AIF, and Madison Capital. In August, the consortium signed the acquisition deal with the shareholders of Start Health, which include Star Health Investments, Apis Partners, ICICI Venture, Tata Capital, etc.
Chennai-based Star Health is India’s first standalone health insurance company. It is currently the largest standalone health insurer in the country. Star Health’s Cheif Operating Officer S Prakash stated that the company has witnessed a 22% growth in fresh policy issuances and 35% growth in overall premiums for the fiscal year 2018-19 so far.
31 October 2018
With the launch of the government funded-health insurance scheme, Pradhan Mantri Jan Arogya Yojana, earlier known as Ayushman Bharat, the demand for phlebotomists is expected to increase immensely. Phlebotomists are basically trained individuals who draw blood from patients for medical and clinical testing as well as transfusions. The health insurance scheme which was designed with the objective to provide free access to medical care. This initiative will further increase the demand for medical professionals in the market. According to experts, the demand will create jobs for another 11,000 phlebotomists over the next year. Due to the current paucity of the professionals, the per month salary of phlebotomists has increased from Rs.20,000 to Rs.24,000. Paul Dupuis, CEO, Randstad India, believes that the demand for haematology services will increase by 40% in the next 1-1.5 years along with the increase in demand for phlebotomists. The situation will be no different even if the government ties-up with private operators. In fact, running the scheme under the PPP model will increase the demand for nurses, pharmacists, and general physicians too.
30 October 2018
Indian Medical Association (IMA) has raised concerns over the implementation of Ayushman Bharat-National Protection Scheme, as the Kerala health department gets ready to sign the MoU with the health ministry in order to become a part of the health scheme.
IMA has shown their concern regarding the rates for the procedures under the health scheme which has been deemed impractical. The association believes that the Kerala state government must look into these procedures before signing the MoU.
IMA convened a meeting of the various organisation in order to discuss the practical difficulty behind the implementation of the health scheme. Several issues such as involvement of middlemen, liabilities to the hospital, impractical rates were discussed. IMA will let know the Central Government the outcome of the meeting.
IMA plans to prepare a report which will also include the cost to be covered under the health scheme.
26 October 2018
The Competition Commission of India (CCI) has released a new policy note on affordable healthcare. The commission noted several industry practices that severely restrict consumer choice. Various initiatives have been identified by CCI to ensure adequate competition in the industry.
Two of the major issues identified by the commission was - the shortage of healthcare professionals owing to the high cost of education and the inadequacy of health insurance. CCI has also identified various issues and provided recommendations to fix these issues.
CCI has shared the policy note with various entities like Ministry of Health, Ministry of Corporate Affairs, NITI Aayog, and Department of Pharmaceuticals. Based on various findings, the commission is expected to incorporate various antitrust rule to ensure effective competition in the healthcare and pharmaceutical sectors in India.
26 October 2018
A recommendation made by the Competition Commission of India (CCI) in its policy note on affordable healthcare may prevent super specialty hospitals from forcing their patients to buy drugs from in-house pharmacies. Under the current method, in-house pharmacies of super specialty hospitals are completely insulated from outside competition. The competition regulator has made a recommendation that hospitals must allow consumers to buy drugs from the open market to ensure competition.
It has also recommended a regulatory framework that ensures portability of patient data from one hospital to another. This procedure breaks the constraints for patients when it comes to switching from one hospital to another. In addition to these factors, the policy note also focuses on various factors affecting competition in the healthcare sector.
The policy note with the identified issues and various recommendations has been shared with various agencies like the Ministry of Health, the Ministry of Corporate Affairs, Ministry of Pharmaceuticals, and NITI Aayog.
26 October 2018
The Ministry of Health and Family Welfare recently notified the Human Immunodeficiency Virus (HIV)/Acquired Immune Deficiency Syndrome (Prevention and Control) Act, 2017, with immediate effect. The Act aims to protect the rights of individuals affected with HIV/AIDS.
The Central Government and State Governments have, thus, been asked to take measures to frame schemes that will address the requirements of the concerned individuals, establish guidelines for the support, care, and treatment of children infected with the disease, facilitate access to various welfare schemes, protect the property of children who are infected by HIV/AIDS, formulate information related to HIV and AIDS, and establish measures to counsel and offer information to HIV-infected women.
Further, State Governments will also be appointing one or more ombudsman to conduct enquiries into any complaints with regard to the violations of any of the provisions of this Act or healthcare services.
25 October 2018
The state government of Maharashtra de-empanelled certain hospitals from Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) post raids conducted by the state-level monitoring teams of the scheme. The raids were carried out in Kolhapur and Sangli and several hospitals were suspended from the scheme. Suspension is the very step taken in case of malpractices by empanelled hospitals and such hospitals are not permitted to conduct surgical procedures for any beneficiary of the scheme. In case a hospital is de-empanelled, the hospital cannot provide any treatment whatsoever under the scheme. The officials of the health ministry found that certain guidelines laid down by the government were not followed – patients were charged for certain treatments and some hospitals even made false cases in order to make claims. The patients who were undergoing treatments in the de-empanelled hospitals were shifted to other private empanelled hospitals. The officials said that the rest of the hospitals will also be scrutinized and if they too are found guilty of not following the guidelines, they will be de-empanelled. In addition, a district coordinator of the state health insurance scheme said that some of the arogya mitra coordinators, who are supposed to help underprivileged patients, will be fired for not carrying out their duties.
23 October 2018
Jharkhand Chief Minister Raghubar Das on Sunday met the representatives of private hospitals like Tata Main Hospital to provide treatment facilities under Mukhyamantri Swasthya Bima Yojana and Pradhan Mantri Jan Arogya Yojana.
Das said that there were various patients who are not employed by Tata Steel and its subsidiaries visit the hospital on a regular basis for treatment and should be provided the facilities under Ayushman Bharat Yojana. Das said that the funding for the infrastructure will be provided by the government.
Around 50% of people who are not employed by Tata Steel and its subsidiaries. The chief minister said that the cost of the treatment as per the scheme will be paid by the government.
23 October 2018
22 October 2018
With the IRDAI directing insurance companies to cover HIV/AIDS under their policies, insurers have found themselves in a spot, with insurance companies unable to determine the premium they should charge in such cases.
As per the IRDAI directive, insurance companies cannot deny cover to HIV/AIDS patients unless backed by actuarial studies. India has a high population of individuals infected with HIV and AIDS, with around 21.4 lakh people infected by the virus in the country in 2017.
Until previously only Star Health and Allied Insurance offered cover for HIV/AIDS.
Health insurance companies are likely to rely on data from international markets to determine the premium for such policies.
19 October 2018
The Insurance Regulatory and Development Authority of India (IRDAI) has set up a committee to standardise the exclusions in health insurance policies. The committee is expected to submit its report within the next two months, and it is expected to announce revised policies based on people’s need to get coverage for non-curable and long-standing diseases.
Based on the revised guidelines, even people with certain forms of auto-immune diseases, cardiac ailments, and diabetes may also get coverage from health insurance companies. It is also believed that the committee is currently evaluating ways to provide coverage for cancer survivors.
The idea behind the standardisation of exclusions is that even people with certain non-curable conditions must receive coverage for other types of health ailments they may face. Once the report is ready, the committee will take two or three more months to provide its final recommendations. It is also expected that the committee will be able to provide clarification on the mental illnesses covered by health insurance policies.
19 October 2018
A panel has been formed by the IRDAI to research the feasibility of claim payments through instalments. The committee will look at both, general and health insurance claims as part of its research.
A few insurers (health and general insurance) have proposed an option to pay claims in instalments when it comes to benefit-based policies and personal accident policies. This could benefit beneficiaries, who will get the claim amount at regular pre-determined periods.
The panel formed by IRDAI will be headed by Suresh Mathur, the ED (Health) of IRDAI.
18 October 2018
The state government of Punjab has signed a memorandum of understanding with the Central Government to implement the Pradhan Mantri Jan Arogya Yojana (PMJAY) throughout the state. The state government has revealed that the scheme will be available 43 lakh families in the state instead of the 14.96 lakh families originally proposed.
According to Chief Minister, Amarinder Singh, this scheme will make sure that quality healthcare is within the reach of all needy people. The state government has merged the PMJAY with the state-run health insurance scheme Bhagat Puran Singh Sehat Bima Yojana (BPSSBY). Following this merger, the sum insured amount has been increased to Rs.5 lakh per family instead of the original Rs.50,000.
PMJAY, commonly known as Ayushman Bharat, was announced by the Central Government in the previous budget session. The statement released by the the Punjab government noted that a pilot version of the scheme will be launched before the official launch throughout the state.
18 October 2018
The Chief Minister’s Health Insurance Scheme (CMCHIS), which is run by the State Government of Tamil Nadu, has won the “The Best Use of Technology in Health Insurance” award at the e-India Health Summit.
The CMCHIS scheme provides people residing in the state access to healthcare facilities via 700+ network hospitals that are located in various parts of the state. Both private and public hospitals have been empanelled under the scheme.
It is estimated that almost 15 million families residing in Tamil Nadu have benefitted from the health insurance scheme, which provides the enrolled members a much-needed cover against hospitalisation expenses. The state-backed scheme is implemented by Madras Security Printers Pvt. Ltd., which received a “Certificate of Recognition” for successfully implementing this project at the International Conference on Health Insurance.
13 October 2018
The Government of India has stated that it is rejecting the findings of the World Bank’s Human Capital Index (HCI) after being placed in 115th position behind countries like Bangladesh, Nepal, Myanmar, and Sri Lanka. The government noted that this report does not consider the initiatives being taken by the country to develop human capital.
The Finance Ministry of India has pointed out various initiatives taken by the government to improve human capital. For instance, the Ayushman Bharat scheme aims to provide health insurance coverage for 50 crore individuals in the country. The Pradhan Mantri Ujjawala Yojana has improved the health of women by replacing firewood based stoves with LPG stoves in about 38 million households.
The Finance Ministry has also cited other schemes like Aadhar and Pradhan Mantri Jan Dhan Yojana in developing human capital. The government noted that it will ignore the HCI report and continue to undertake measures that contribute to human capital development.
Among the 157 economics evaluated in the report, India is placed at 115 based on various parameters like health, education, child mortality, etc.
13 October 2018
Mr. JP Nadda, the Union Health Minister, recently said that creating and enabling trade and legal environment for public health and access to medical products are key to achieving the Sustainable Development Goals (SDGs) 2030 Agenda.
Mr. Nadda further mentioned that universal health coverage was an important factor in achieving the Sustainable Development Goals, during the inauguration of the ‘2nd World Conference on Access to Medical Products: Achieving the SDGs 2030’.
He also spoke about the Ayushman Bharat – Pradhan Mantri Jan Arogya Yojana, which was launched on September 23. He mentioned that over 50,000 people have enrolled under the coverage of the scheme. The PMJAY scheme envisions to provide health insurance coverage to over 50 crore families. The scheme will provide a cover of Rs.5 lakh per family on an annual basis.
12 October 2018
The National Health Agency (NHA), which is responsible for implementing Ayushman Bharat in India, has now revealed that families with monthly income over Rs.10,000 and those that own a refrigerator or two-wheeler will be excluded from this scheme. Since the scheme aims to provide coverage only for the poorest sections of the society, it excludes families with the above-mentioned qualifications.
In rural households, this scheme excludes people who own over 2.5 acres of irrigated land along with irrigation equipment. Also, people who have owned 5 acres or more of irrigated land and irrigation equipment for at least two crop seasons are excluded. These exclusions are based on the Socio-Economic and Caste Census (SECC) of 2011.
The Pradhan Mantri Jan Arogya Yojana (PMJAY), popularly known as Ayushman Bharat, was launched by the reigning NDA government to provide health insurance coverage for poor people in India. This scheme provides coverage worth Rs.5 lakh for about 50 crore individuals belonging to 10 crore individuals on a family floater basis.
12 October 2018
Employee State Insurance Corporation (ESIC) won the ISSA Good Practice Award for the measures taken by the body for raising the wage limit for the coverage as per the ESI act, extending the coverage of the Scheme for Promoting Registration of Employers and Employees (SPREE), and reducing the rate of contribution rates for two years at the Regional Social Security Forum for Asia and Pacific which was held at Kuala Lumpur, Malaysia.
Raj Kumar, IAS and Director General of ESIC, received the certificate of merit on behalf of the corporation.
11 October 2018
Union Health Minister J P Nadda said that the key to achieving the Sustainable Development Goals Agenda 2030 is by providing proper access to medical products and creating a legal and trade environment for public health.
Sustainable Development Goals (SDGs) which came into effect in January 2016 aims to end poverty, protect the earth and ensure that all the people live in harmony with each other. SDGs will continue to guide and fund the United Nations till the year 2030.
Nadda said that universal health coverage is one of the methods through which SDGs can be achieved and called for continuous dialogues with other ministries in order to achieve the public health goals.
11 October 2018
The Insurance Regulatory and Development Authority (IRDA) has asked the insurance companies to stop discriminating and provide cover to people who suffer from HIV/AIDS.
According to a report by the National AIDS Control Organisation, there are approximately 2.14 million people in India who suffer from HIV/AIDS.
The decision comes after it was made mandatory under the HIV and AIDS Act 2017 that people suffering from the disease cannot be denied insurance by an insurance company.
IRDA back in 2013 had asked the insurance company to provide insurance cover to people suffering from HIV/AIDS. However, the insurance companies had pointed out that they would face in adequately pricing the product since they did not have enough data to help them do so.
Star Health, however, became the first insurance company in India to provide cover to the people suffering from HIV/AIDS.
The insurance companies do not have any option but to comply with the latest order directed by the IRDA. However, the insurance companies feel that the premiums payable will be extremely expensive. For example, if the average health insurance premium is Rs.7,000 on a yearly basis, then a person suffering from HIV/AIDS will have to pay almost three times the average premium amount.
11 October 2018
As per news reports, a parliamentary panel will examine the implementation of the Modi-led health insurance scheme – Pradhan Mantri Jan Arogya Yojana (PMJAY). The Parliamentary Standing Committee on Health headed by Ram Gopal Yadav will look into the implementation of the ambitious health insurance scheme. Since the objective of the health insurance scheme is to provide health insurance to the needy as well as improve the health and wellness infrastructure, the parliamentary panel will also look into the operations of AIIMS and other medical institutions. In addition, the panel will focus on the affordability of treatments like duchenne muscular dystrophy and cancer.
PMJAY will provide cashless and paperless services to beneficiaries of the health insurance scheme. The beneficiaries will be picked based on the latest Socio-Economic Caste Census data. PMJAY, popularly known as Ayushman Bharat, was launched on September 23 and more than 50,000 underprivileged people have benefitted from the scheme. The scheme will provide benefits up to Rs.5 lakh per family every year. More than 14,000 hospitals, public and private, have been added to the network to this end. Till date, 32 states and union territories have signed MoUs to provide benefits under the health insurance scheme.
9 October 2018
The National Health Agency (NHA), which was given the responsibility to manage the Pradhan Mantri Jan Arogya Yojana (PMJAY), has requested the Finance Ministry for additional funds equal to Rs.4,500 crore for the remaining months of FY2018-19. The ministry had allocated Rs.2,000 crore earlier and the same was used up for the initial operations of the universal health insurance scheme. The funds are in no way problematic in the implementation of the scheme. The health insurance scheme, which was earlier called Ayushman Bharat – National Health Protection Scheme, will provide medical coverage up to Rs.5 lakh per family to the low socio-economic class of the society. As per an analysis published in the Indian Journal of Community Medicine, the premium for each family was estimated at Rs.2,000 making the overall budget Rs.20,000 crore considering 10 crore families will benefit from the scheme. Another estimate by Niti Aayog, however, revealed that the yearly budget for the health insurance scheme would add up to Rs.10,000 crore. An expert from Public Health Foundation of India said that though the costs are going to be shared between the Centre and the State, the government should have allocated at least Rs.6,000 crore in advance.
4 October 2018
The Insurance regulator, IRDAI, has provided permission to life, general, and health insurance companies to offer micro-insurance plans through Point-of-sales (PoS). This was done with the objective to increase the insurance penetration in India which is quite low currently. Micro-insurance plans are specially designed products with a low premium payable amount that are suitable for the economically backward class of the country. The sum insured amount of such policies is Rs.50,000. The low prices and increased number of options make them beneficial products that will eventually lead to high insurance penetration in the long run.
Further, the IRDAI has done away with the requirement to prefix ‘PoS’ to the names of insurance plans that are sold through PoS. Earlier, it was mandatory for insurance companies to prefix ‘PoS’ to the name of the insurance plan to make it easy to identify policies that are sold through the PoS medium. However, under IRDAI’s Protection of Policyholders’ Interest Regulations of 2017, providing the details of the Point-of-Sales Persons was made mandatory. Therefore insurance companies asked the IRDAI to eliminate the regulation of prefixing ‘PoS’.The IRDAI, hence, concluded that there was no need to prefix ‘PoS’ as the policy document would make it clear about the medium of sales.
4 October 2018
Within a week after the launch of the Pradhan Mantri Jan Arogya Yojana (PMJAY) in Maharashtra, 154 beneficiaries have been enrolled in this scheme in various districts of the state. State records also indicate that 79 government hospitals have empanelled in this scheme so far. This scheme will provide coverage for about 1,300 medical procedures for a total value of Rs.5 lakh.
In Maharashtra, PMJAY will be implemented parallel to the state’s existing health insurance scheme Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) similar to the hybrid model implemented in Gujarat and Rajasthan. In the state, this scheme is expected to provide coverage to 83 lakh beneficiaries. Throughout the country, it will provide health insurance coverage to over 10 crore families.
Till date, private hospitals have been kept out of the scheme by the government. However, it is likely that the empanelment of private hospitals will begin by the end of this year. Due to the lack of private players, the options are limited for patients seeking treatment for super-specialty procedures.
3 October 2018
Having announced the launch of what would become the world’s biggest health care scheme in the world, the Prime Minister gave more good news to the citizens that will be covered by the scheme. Rolled out under the Pradhan Mantri Jan Arogya Yojana (PMJAY)., the Ayushman Bharat, which is also known as Modi Care, as labelled by the media after the Obama Care, will offer coverage for urological disorders as well. According to doctors, for males in the country, following oral cancer, prostate cancer sees the most number of people diagnosed by the killer disease. According to a representative of the scheme, Delhi Cancer registry shows cancer of the prostate is the second most frequently diagnosed cancer among men in Delhi where the incidence of cancer is 10-12 percent and after oral cancers, the prostate is the leading problem. He added by saying that through the Ayushman Bharat scheme, the government, in consultations with healthcare providers has fixed up charges for treatments for all urological disorders and that will be reimbursed by the insurers. The Ayushman Bharat is all set to aid more than 500 million individuals and 10 lakh plus families across the country who are below the poverty line. Each family will receive a sum assured of Rs.5 lakh for hospitalisation every year.
2 October 2018
In what would be considered historical for the citizens of the country, a few months back, the Prime Minister of the country, Narendra Modi announced that the country will be home to the world’s largest healthcare service in the world. He called it the Ayushman Bharat scheme will the media were quick to give it a more personal touch and call it Modi Care. The Prime Minister said that the scheme will offer health coverage for hospitalisation and will be serving the poorest of the poor in the country. The scheme which will cover 80 lakh families and more than 500 million individuals in total will offer a coverage of Rs.5 lakh for each family every year to take care of hospital expenses. Of course, since the cost of the scheme will be shared by the state governments as well, some states have opted for it while some others have decided to give the scheme a miss. One such being the Telangana Government. The decision of the Telangana Government has drawn some ire from the Union Minister Smriti Irani, who has completely slammed the decision of the government. She said, the Telangana government has said it was not joining "as of now" the Pradhan Mantri Jan Arogya Yojana-Ayushman Bharat, launched by Prime Minister Narendra Modi on September 23, citing the state's Aarogyasri scheme which covers nearly 80 lakh families effectively. She concluded by saying that unfortunately, the TRS government did not understand the importance of this scheme which provides Rs 5 lakh health cover for 1,300 illnesses, including cancer and tuberculosis.
2 October 2018
It seems like the Pradhan Mantri Jan Arogya Yojana is moving forward at a slow pace in certain regions with only 250 people registering for it in Panchkula, Haryana. According to the socio-economic survey of 2011, there are about 26,000 beneficiaries in this region. If registration continued at this pace, it might take up to seven to eight months to prepare gold cards for all the beneficiaries.
So far, six hospitals in this region has been empanelled by the company for providing treatment to enrolled members. The applications of another five to six hospitals are yet to be processed. All over Haryana, about 180 hospitals have been empanelled in this scheme.
According to the scheme’s Chief Medical Officer Dr. Yogesh Sharma, various healthcare professionals have been deputed to spread awareness about the scheme in this region. He noted that village secretaries and sarpanches are also enrolled to spread awareness about the scheme in various regions of the state.
1 October 2018
A mega health mela was launched in Arunachal Pradesh recently, with Kiren Rijiju, MoS for Home Affairs launching it. The mela is being organised by the district health society and the district administration and aims to educate the population about health conditions.
The mela, funded by the National Rural Health Mission saw a number of patients registering their names.
The launch also saw Rijiju speak about the health insurance scheme implemented by the government of India. The scheme will cover around 50 crore people, with provisions to provide a sum of Rs.5 lakh to each patient.
28 September 2018
Following the judgement of the Supreme Court with regards to the validity of Aadhar, insurance companies cannot deny a claim if the insured does not have an Aadhar. There have been instances in the past when insurance companies have mandatorily asked for the Aadhar of a policyholder/insured to settle a claim. Insurance companies have also asked the Aadhar details while selling a policy in the past.
Following the Supreme Court verdict, only government agencies can seek Aadhar details. According to certain news reports, IRDAI could soon come up with new directives to insurance companies regarding Aadhar.
28 September 2018
Prime Minister Narendra Modi asked the Chief Minister of Odisha, Naveen Patnaik, to link the underprivileged mass in Odisha to the national health insurance scheme, Ayushman Bharat. The scheme provides Rs.5 lakh coverage for each family. The scheme will, therefore, provide financial aid to 10 crore households in the country to manage medical expenses arising from serious illnesses. The PM made the statement in a public gathering during his one-day visit to Talcher to launch a coal gasification-based fertilizer plant. This fertilizer plant is the first of its kind in India and is being set up in the Angul district of Bhopal. While emphasizing the need to include the members of the state of Bhopal under the highly beneficial national health insurance scheme, Modi highlighted a statement made by the former Prime Minister Rajiv Gandhi. Gandhi had said that only 15 paise of every rupee actually reaches the beneficiaries and the rest is lost due to corruption. With the intention to eliminate such losses, the Ayushman Bharat transfers the benefit amount of the health insurance scheme directly to the concerned beneficiary’s bank account. Modi pointed out the fact that a large number of people had gathered at the launch which clearly shows that the people are interested in the initiative taken by his government.
27 September 2018
The Central Government of India has launched the Pradhan Mantri Jan Arogya Yojana (PMJAY) on September 23. The national health insurance scheme provides an insurance cover of Rs.5 lakh to around 10.74 crore families in the country. The scheme was launched by Prime Minister Narendra Modi at a recent event in Ranchi.
The PMJAY scheme will provide cashless hospitalisation facility to beneficiaries. Furthermore, the scheme covers over 1,350 illnesses including heart disease, cancer, joint replacement, and strokes, in addition to providing emergency care for injuries. Over 50 crore individuals from economically weaker sections of society will be able to avail health coverage with the PMJAY scheme.
Eligible individuals will be able to avail treatments at any one of the 13,000 private/government hospitals that are expected to be empanelled in the near future. The health insurance scheme will cover the costs of diagnostics, day-care treatments, surgery, and medicines.
Further, the Union Health Ministry is also looking to provide free-of-cost primary level healthcare services to individuals through wellness centres that are likely to be established over the next few years. The Prime Minister has said that a total of 2,300 wellness centres have already been established in the country.
26 September 2018
All India Institute of Medical Sciences (AIIMS) became the first Delhi-based medical institute to have signed a Memorandum of Understanding (MoU) with National Health Agency (NHA) so as to implement Pradhan Mantri Jan Arogya Yojana - the health scheme launched by Narendra Modi the Prime Minister of India.
The beneficiaries will be provided all the therapeutic and diagnostic facilities as per the provision of the health schemes. The scheme promises to provide a health cover of Rs.10 lakh each to over 10 crore families in India who are economically backward. Around 98% of the beneficiaries under this scheme have been identified, while NHA is busy sending letters from the PM to the beneficiaries informing about how the scheme and how to access the benefits.
26 September 2018
In what would be the biggest healthcare service in the world, on Independence day, the Prime Minister of the country, Narendra Modi, announced that the Ayushman Bharat healthcare scheme will be launched on September 25, 2018. The scheme, which is also known as ModiCare, will be instrumental in the future of the country as according to reports, more than 500 million people who are the poorest of the poor will receive the healthcare coverage from the Ayushman Bharat. The scheme will give hundreds of thousands of families a sum assured of Rs.5 lakh for treatment and hospitalisation every year. The scheme which is supported by the State Governments can either choose the Insurance Model or the Trust Model. With the Trust model some states have chosen, the premium will be directed from the Trust to the corpus of the insurer, with the Insurance Model, the citizen will have to pay the premium for the insurance policy. According to V Jagannatha, the MD of Star Health Insurance, in our opinion, it will be advantageous to the government to run the scheme on insurance model. More so, for companies like Star Health Insurance, that have a track record of managing large insurance schemes, will use its rich experience in effectively implementing the scheme. With regard to the benefit the scheme will provide for insurers, an agency said, we still expect that insurers with scale advantages and track records of managing large insurance schemes will benefit from the health programme. Additionally,the programme will provide these insurers with opportunities to cross-sell other products and services to this new customer base.
25 September 2018
With the country on the brink of having the world’s largest healthcare scheme rolled out in September 2018, State Governments across the country are also doing their part to make sure that their employees are insured as well. The Ayushman Bharat scheme, which is also known as ModiCare after the Obama Care - the United States former president, will insure more than 500 million people and over 10 lakh families will be insured for 5 lakh a year for hospital expenses and treatments. With the Ayushman Bharat on the verge of being rolled out, with 25 September 2018 being set as the date for its launch, the Srinagar Government announced that they will be rolling out their very own state healthcare scheme in association with Reliance Insurance. According to Navin K Choudhary, principal secretary, Finance, the scheme will be mandatory for all state employees and public servants, including journalists as well as those of the armed forces. Government pensioners are also part of the scheme which gives them an annual sum assured of Rs.6 lakhs, for a premium cost of Rs 8,777 and Rs 22,229 for government employees and for pensioners. The Finance secretary of the State added that the annual premium for the insurance cover of Rs 6 lakh would be Rs 8,777, which would be deducted in four quarterly instalments of Rs 1,295 on October 1, January 15, April 15 and the last instalment of Rs 1,292 on July 1 each year. He announced just yesterday the scheme which was reported by Tribune India.
24 September 2018
Mr. Raghubar Das, the Chief Minister of Jharkhand, recently announced that a total of 57 lakh families, which amounts to 85% of the total population of Jharkhand, in the state will be covered under the Ayushman Bharat scheme. The Ayushman Bharat Yojana will be launched in Jharkhand by Prime Minister Narendra Modi on September 23.
Mr. Das also mentioned that 200 hospitals in the state have been empanelled for the Ayushman Bharat Yojana. Thus, beneficiary families will be able to undergo treatments free-of-cost at these hospitals. Each beneficiary will receive a cover of Rs.5 lakh on an annual basis under the Ayushman Bharat scheme.
The chief minister also added that the people who are not covered under the Ayushman Bharat scheme in the first phase will be included under the scheme during the next phase.
21 September 2018
The Insurance and Regulatory Development Authority of India (IRDAI) has suggested the idea of a regulatory sandbox to push for innovations in the insurance and fintech space.
IRDAI believes that a regulatory sandbox will provide them with space to carry out experiments related to fintech solution in a safe and conducive environment.
The regulatory body in its bid to bring the suggestion to life has formed a 10 member committee which has names like Randip Singh Jagpal, one of the CGMs of IRDAI, Mayank Bathwal the CEO of Aditya Birla Health Insurance, Subrat Mohanty from the HDFC Standard Life Insurance, etc.
IRDAI said that it will look into various issues such as the issues which the insurance sector may face due to fintech, the developments in fintech services, practices followed by different firms from the banking and lending sector. The committee will look to seek feedbacks from various insurance industry participants and prepare a draft consultation paper in the coming two months.
20 September 2018
Mr. Sudhansh Pant, Joint Secretary, Government of India, recently held a meeting to review the progress of the Ayushman Bharat scheme at the State Health Directorate. In the meeting, he said that Uttrakhand is likely to be the first state in India to include all families residing in the state under the Ayushman Bharat scheme, apart from the 5.37 lakh families that were initially identified.
Mr. Sudhansh Pant has also said state governments should ensure that hospitals receive the payments for treatments undertaken by enrolled members in an expedited manner in order to boost empanelment rates among private hospitals. He added that around 40 to 50 prominent private medical establishments in the country are expected to be empanelled under the Ayushman Bharat scheme shortly.
Mr. Trivendra Singh Rawat, the Chief Minister of Uttarakhand, will be launching the Ayushman Bharat scheme in the state on September 23.
19 September 2018
The Member of Parliament of the Mangaldoi Lok Sabha, Ramen Deka, addressed a health camp gathering that comprised of workers of ASHA and Anganwadi. He spoke about how the NDA government has focused on creating a disease-free country and has also emphasised on the importance of health care in India. The several welfare schemes launched for the benefit of the rural public are also centred around health. The schemes launched by the central government such as Ujjawala and Swacch Bharat focus on maintaining cleanliness so as to prevent diseases. The MP, who attended the day long health camp as the chief guest, appreciated the plan of the national health insurance scheme, Ayushman Bharat. He believes that the new scheme will make health care accessible to nearly half the population of the country. Being one of the biggest national health insurance schemes to be backed by the government, it will provide health insurance coverage equal to Rs.5 lakh per annum to 100 million underprivileged families of the country. The health camp conducted at the Tangla HS School playground in Udalguri was organized by the District Health Society of Udalguri’s National Health Commission. The event was chaired by DC Dilip Kumar Das.
18 September 2018
The state of Chhattisgarh has recently commenced the pilot run of the Ayushman Bharat health insurance scheme. The scheme was launched by Prime Minister Narendra Modi in Bijapur district of Chhattisgarh in April 2018.
The National Health Protection Scheme, which will be launched across the country on September 25, will provide health insurance coverage to a total of 107.4 million economically vulnerable families. In Chhattisgarh, the pilot version of the scheme will begin in 1,033 hospitals across various parts of the state, with 608 of these hospitals being public hospitals and 425 hospitals being privately run. The State Government of Chhattisgarh has made all the required preparations to ensure that the scheme is successfully executed in the state. Further, the state government authorities are all set to issue smart cards to people residing in the state as soon as the central government gives its approval for the same. The State Government of Chhattisgarh is looking to provide health insurance coverage to the four million families that are already enrolled under the state-run Mukhyamantri Swasthya Bima Yojana (MSBY) scheme. The state government had previously increased the insurance cover for hospitalisation under the state-run scheme to Rs.50,000 from Rs.30,000. The individuals enrolled under the MSBY scheme will now be enrolled under the Ayushman Bharat scheme and will be provided health insurance coverage for Rs.5 lakh.
18 September 2018
The Chief Minister’s Health Insurance Scheme has been merged with the Pradhan Mantri Jan Arogya Yojana (Ayushman Bharat) in Tamil Nadu. Existing beneficiaries of the state scheme will now receive an additional coverage worth Rs.3 lakh as they get transferred to the new central government scheme.
The scheme came into effect after state health secretary J Radhakrishnan signed the memorandum of understanding with the central government officials for the implementation of Ayushman Bharat. State health minister C Vijayabaskar noted that nearly 10 lakh families that are not enrolled in the state scheme will be added to the Pradhan Mantri Jan Arogya Yojana scheme.
The existing scheme offered by the Tamil Nadu state government now provides coverage for up to 1,027 medical procedures. This existing scheme is limited to low-income families that earn less than Rs.72,000 per year. This scheme also provided health cover for people receiving social security benefits under various government schemes.
The Ayushman Bharat scheme provides coverage worth Rs.5 lakh per family on a family floater basis. This scheme aims to provide coverage for up to 10 crore families throughout the country.
16 September 2018
The head of the insurance regulator, Subhash Chandra Khuntia, has said that mental health, as well as genetic disorders, will be covered under health insurance policies. Insurance Regulatory and Development Authority of India (IRDAI) will take a look at the report compiled by a committee that wishes to decrease and standardise the exclusions laid down by companies in health insurance products. After an analysis of the report, the regulator will take a decision regarding the exclusions. The chairman is of the opinion that a few of the exclusions of the policy are not desirable and should not be permitted. The elimination of the genetic disorder exclusion came in on March 19 after the High Court of Delhi passed an order saying that the exclusion is illegal. The ruling to remove the mental health exclusion was passed on August 16 by IRDAI. The elimination of these two core exclusions will benefit the insured members immensely but insurance providers are of the opinion that it will lead to an increase in the premium amount payable. The elimination of these exclusions will increase the risk carried by insured persons and will hence cost more.
15 September 2018
With Bajaj Allianz currently one of the top players in the country in the Life Insurance sector, the insurer is looking to spread its wings and has done so by nudging into the health insurance sector with the Bajaj Allianz Life Health Care Goal policy. With just a single Bajaj Allianz Life Health Care Goal, policyholders can insurer their family up to 6 members. CEO Tarun Chugh, said that the Bajaj Allianz Life Health Care Goal policy is unique as it offers the sum assured as soon as the person or the policyholder is diagnosed with the illness unlike other insurers that offer the sum assured after the treatment of the illness or following the death of the policyholder. According to the Managing Director and the CEO of Bajaj Allianz Life, he said that the policyholder has the benefit of the return of premium option if no cover has been availed during the tenure of the policy. The Bajaj Allianz Life Health Care Goal policy comes with two variants that policyholders can opt for based on their requirements.
12 September 2018
The Pradhan Mantri Jan Arogya Yojana, also known as Ayushman Bharat, will also provide coverage for childhood cancer according to Dr Vinod Kumar Paul, a member of Niti Aayog. He made this statement while giving a speech at the 10th Annual National Childhood Cancer Excellence Awards Programme in New Delhi. The event, organised by Cankids, witnessed the participation of about 100 cancer survivor kids from different parts of the country.
He stated that this scheme will provide coverage for childhood cancer and the rate has been fixed for treatment under this scheme. He also noted that over 1.5 lakh dedicated health and wellness centers will be opened under this scheme by the year 2022.
The Ayushman Bharat scheme was launched by the government to provide health insurance coverage for underprivileged and lower middle class families in the nation. Families enrolled in this scheme will get coverage for Rs.5 lakh on a family floater basis. This scheme provides coverage for up to 5 members in a family.
12 September 2018
The State Government of Tamil Nadu recently signed a MoU with the Central Government to implement the Ayushman Bharat scheme in the state in association with the Chief Minister’s Comprehensive Health Insurance Scheme. The MoU was signed in the presence of C. Vijaya Baskar, the Health Minister of Tamil Nadu, in the DMS campus.
Once the Pradhan Mantri Jan Arogya Yojana (PMJAY) is implemented in the state along with CMCHIS, it is expected that nearly 77 lakh economically vulnerable families will receive much-needed health insurance cover of Rs.5 lakh per family on an annual basis for secondary and tertiary care hospitalisation. Thus, once the Pradhan Mantri Jan Arogya Yojana is implemented, individuals who are not covered under the CMCHIS will be included in the PMJAY scheme. CMCHIS beneficiaries in Tamil Nadu, regardless of whether they are covered under the NHPS or not, will receive coverage of Rs.5 lakh every year.
The Chief Minister’s Comprehensive Health Insurance Scheme provides coverage to a total of 1.57 crore families in Tamil Nadu. Beneficiaries are provided coverage of Rs.1 lakh for a total 1,027 procedures, in addition to receiving a cover of Rs.2 lakh annually for 154 specified procedures. Furthermore, the State Government has also maintained a corpus fund to provide treatment to a total of 8 high-end procedures.
12 September 2018
Insurance Regulatory and Development Authority of India (IRDAI) which had earlier passed an order asking the health insurance companies not to reject claims related to genetic disorder has currently put the order on hold.
This means, that the health insurance companies at least for time being are under no regulation to provide cover to those suffering from any form of genetic disorders.
The regulatory body has initiated the move after the Supreme Court last week had partially stayed an order saying that not providing cover to people suffering from genetic disorder was unconstitutional in nature.
The Delhi Court in February had said that exclusions related to genetic disorders were too ambiguous, broad, and discriminatory in nature.
The Delhi Court had asked the IRDAI to have a look at the exclusion clauses related to the genetic disorder and ensure that people suffering from genetic disorder get their rightful claim and do not suffer. The regulatory body post the order had asked all the health insurance companies not to reject any claims related to genetic disorders.
The insurance companies after the latest ruling from the Supreme Court of India has said that they will be waiting for further clarity on the order passed by the apex court in India.
8 September 2018
Prime Minister Narendra Modi is all set to launch the government’s ambitious health insurance scheme ‘Ayushman Bharat’ on September 23 from Jharkhand. The state’s health secretary Nidhi Kare confirmed the event stating that it is a proud moment for the state to launch the new health insurance scheme. He also stated that the PMO has confirmed the arrival of the Prime Minister on September 23.
The health secretary also noted that the state is ready to roll out programme that could benefit as much as 85% of the state’s population. Jharkhand’s chief minister Raghubar Das reacted to the news by thanking the Prime Minister for choosing the state to launch this scheme.
The Ayushman Bharat scheme provides cashless medical treatment for up to Rs.5 lakh per family on a family floater basis. So far, 240 private hospitals have applied to be empanelled under this scheme. An empanelment committee has been set up in various district to verify these hospitals before approving them for the scheme.
Following the launch of this scheme in Jharkhand, it will be implemented in other states across the country in a phased manner.
7 September 2018
The Yogi Adityanath led Government today started a 10-day trial run of the newly launched Ayushman Bharat-National Health Protection Scheme popularly known as the Modicare across all the districts in UP.
The trial run of the health scheme was launched formally by the state health minister Sidharth Nath Singh Balrampur Hospital. The trial run would continue till September 13 before it is formally launched on September 25.
The government health scheme promises to provide Rs.5 lakh as health cover to each family who belongs to economically weaker classes.
The State Agency for Comprehensive Health and Integrated Services (SACHIS) has been given the responsibility of to manage the claims of the people enrolled under the scheme, while a 13-member governing body which is headed by the chief secretary of the state will be monitoring the entire process.
The hospitals which are enrolled under the scheme will be monitored by an Ayushman Mitra and will help the beneficiaries with all the claim-related processes. Each Ayushman Mitra will be given an honorary amount of Rs.5,000 per month and Rs.50 for each successful processing of the claim.
There are close to 1,000 hospitals enrolled under the scheme while the Yogi Adityanath led government has sanctioned Rs.4.40 billion for the smooth running of the health scheme in the state.
6 September 2018
According to Uttar Pradesh Health Minister Siddharth Nath Singh, the Pradhan Mantri Jan Arogya Yojana (PMJAY) scheme incorporated by the government will benefit about 1.18 crore families in the state. It is estimated that this scheme is likely to cover as many as six crore individuals living in the state.
The minister noted that the beneficiaries of this scheme will be identified from the 2011 census. However, the scheme will be later extended to include those who got left out of the 2011 census. He also noted that beneficiaries are mainly from the scheduled caste and scheduled tribe segments.
The PMJAY, also known as Ayushman Bharat, is intended to provide coverage worth Rs.5 lakh per family on a floater basis. The minister stated that this scheme will also provide coverage for various daycare treatments such as laser operation and dental treatments.
6 September 2018
With the Rajasthan polls just looming around the corner, the Chief Minister of the state has announced that the citizens of the state will be given Rs.500 to buy a mobile handset, and an additional Rs.500 will be given to them as a second installment to for internet connection. The Chief Minister added that if the phone is not purchased with the initial installment of Rs.500, then the second installment of Rs.500 will not be given. The contribution from the Rajasthan Government to families will come under the ‘Bhamashah Scheme’. The Chief Minister along with the announcement said that the opposition has failed with regard to offering free medical treatment to his people. He said that the opposition despite their promises have allocated just Rs.300 crores while is government has churned out Rs.2,100 crore for the same case. The opposition however hit back by saying that if someone is getting benefits from a government scheme, the government is not doing a favour. It’s the government’s job to provide schemes. Whatever promises they are making today, from giving money for phones to internet, they are doing it to hide their failures.
6 September 2018
The Central Government has urged Odisha to join the Ayushman Bharat scheme stating that this scheme will remain incomplete without the participation of Odisha. Odisha has earlier rejected the scheme on account of launching its own health coverage scheme named ‘Biju Swasthya Kalyan Yojana’. This scheme aims to cover about 3.5 crore individuals belonging to 70 lakh families in the state.
According to Ashwini Kumar Choubey, Union Minister of State for Health and Family Welfare, the Ayushman Bharat Programme will remain incomplete without the participation of Odisha. Despite congratulating the state on its own scheme, he urged that Odisha must consider the advantage offered by Ayushman Bharat.
The state rejected the scheme mainly because the Ministry of Health and Family Welfare asked the state government to limit the beneficiaries to 61 lakh families. However, the state wanted to enroll 70 lakh families. The state launched the Biju Swasthya Kalyan Yojana on August 15 coinciding with the launch of Ayushman Bharat.
5 September 2018
The Ayushman Bharat- Pradhan Mantri Jan Arogya Yojna (AB-PMJAY) saw its first claim in Haryana days before its official launch in the country. The claim was for the birth of a baby girl through a caesarean section. The Union Health Ministry, under the Ayushman Bharat scheme, provided an amount equal to Rs.9,000 to Kalpana Chawla Hospital, Haryana for the treatment. The Deputy Chief Executive Officer of Ayushman Bharat, Dinesh Arora, tweeted about the first claim. The AB-PMJAY is an ambitious health insurance scheme that was announced in this year’s budget session and is expected to provide a health insurance coverage equal to Rs.5 lakh to each underprivileged family in India. While the scheme is going to be officially launched on September 25, the pilot project is being run in 16 states and union territories. The pilot test is being conducted to check the software with regard to transaction management and identification of beneficiaries. Once the scheme is launched, eligible beneficiaries can avail benefits under the plan up to 3 days prior to admission to the hospital and 15 days post discharge from the hospital. Each network hospital will have a Pradhan Mantri Arogya Mitra who will aid the insured members with the claims process.
4 September 2018
In an effort to prevent patients from having to undergo needless medical procedures while getting hospitalised or treated, the State Government of Maharashtra will be introducing a clinical protocol for the Mahatma Jyotiba Phule Jan Arogya Yojana (MPJAY) scheme, which is the Maharashtra government’s cashless health insurance scheme.
Thus, the protocol will prescribe the procedures to be conducted and the line of treatment to be followed based on the symptoms suffered by the patient and the resulting diagnosis given by the medical practitioner. The clinical protocol, which is in its last stages, will be put up online to bring more accountability, objectivity, and transparency on part of the medical establishments in the state.
The MPJAY scheme provides health insurance coverage to around 2.25 crore APL and BPL ration card holding families in the state. Nearly 1,000 patients are enrolled on an everyday basis for various treatments under this scheme. A total of around 3.5 lakh procedures are conducted on an annual basis. The State Government of Maharashtra pays a sum of Rs.1,600 crore as the annual premium to the insurance provider.
4 September 2018
With more and more people failing to have an insurance policy for their vehicle, the Government is all set to revamp the comprehensive car insurance scheme through its latest amendments. Firstly, since more than 60% of the vehicles on the roads in India are uninsured, the Government of India has recently made it mandatory for vehicles on the roads of India to have a long-term third party insurance. The amendment is applicable for both cars and bikes and cars will have to have an insurance for a span of 3 years while bikes must have a insurance policy of 5 years. This means that the premiums of third party insurance policies are going to get dearer, but vehicle owners will be insured for a longer period without having to go through the hassle of renewing their policies every year. Now, the Government has told the regulator to include free medical emergency treatment for road accidents victims through its latest scheme. The latest initiative by the Government will be called trauma care. According to a government official, the idea was to implement the scheme with the help of private and public insurance companies. But as the EoI invited in this regard evoked no response from the companies, we have decided to identify a competent TPA for managing the funds that will be reimbursed to the hospitals which provide treatment to victims of road traffic accidents.
4 September 2018
Mr. J P Nadda, the Union Health Minister of India, recently said that the initiatives for universal health coverage have been fast-tracked. He added that the Union Health Ministry is also working hard to effectively implement the Ayushman Bharat scheme, which, post its implementation, will become the biggest government-funded health insurance scheme globally.
During the 71st session of the World Health Organisation Regional Committee for South-East Asia that was recently held, the Union Health Minister said the India is in support of the global and regional health agenda and that the country is ready to work with member states and the international community in an effort to achieve the shared “Health for All” goal.
The Ayushman Bharat scheme rests on the dual pillars of Health and Wellness Centres to provide comprehensive primary healthcare to people across the country and the Prime Minister’s National Health Protection Mission, which will cover secondary and tertiary healthcare.
4 September 2018
The Central Government has urged Odisha to join the Ayushman Bharat scheme stating that this scheme will remain incomplete without the participation of Odisha. Odisha has earlier rejected the scheme on account of launching its own health coverage scheme named ‘Biju Swasthya Kalyan Yojana’. This scheme aims to cover about 3.5 crore individuals belonging to 70 lakh families in the state.
According to Ashwini Kumar Choubey, Union Minister of State for Health and Family Welfare, the Ayushman Bharat Programme will remain incomplete without the participation of Odisha. Despite congratulating the state on its own scheme, he urged that Odisha must consider the advantage offered by Ayushman Bharat.
The state rejected the scheme mainly because the Ministry of Health and Family Welfare asked the state government to limit the beneficiaries to 61 lakh families. However, the state wanted to enroll 70 lakh families. The state launched the Biju Swasthya Kalyan Yojana on August 15 coinciding with the launch of Ayushman Bharat.
4 September 2018
Manipal Group of Hospitals, along with TTK Group, will hold a 51% stake in the private health insurance company, Cigna TTK, once the Insurance Regulatory and Development Authority of India (IRDAI) approves the proposal. Though the TTK Group had decided to exit the firm altogether, it only trimmed its hold over the company. The Group had considered selling its 51% stake to Manipal Group in the year 2017. However, due to a regulatory issue, TTK Group could not sell its stake completely. Cigna TTK Health Insurance is hopeful of the new partnership and believes that with the entry of Manipal, the company will be able to provide complete healthcare solutions to the country. So, not only will the company help with financing the treatments but will also focus on healthcare delivery. The Chairman of Manipal Education & Medical Group, Dr. Ranjan Pai, is of the opinion that the two organisations, together, will change the concept of healthcare in India. TTK, according to sources, will exit the partnership in the near future. Cigna TTK Health Insurance was set up in the year 2014 and has over 1 million customers across the country.
3 September 2018
The Chandigarh health department has found that 31,000 families out of the total 71,278 families do not exist. The Socio-Economic Caste Census of 2011 could only find 23,000 families existing and being eligible for the newly launched government health scheme.
According to the census, it was found that there were total 2,14,233 families in India, out of which 71,728 were economically backward families. However, the Chandigarh health department after validating the records could only confirm 23,678 families to be economically backward.
A total of 31,062 families do not exist while 14,028 families have migrated to another state. 2,501 families cannot be contacted which leaves only 23,678 people to be eligible for the government health scheme.
Out of the 23,687 people eligible for the scheme, 23,295 people belong to the urban areas while 392 people are beneficiaries from the rural areas.
31 August 2018
The Insurance Regulatory and Development Authority of India (IRDAI) has allowed 10 more insurance companies to provide medical treatment in its list of covers offered by the health insurance companies.
The regulatory body in its list of guidelines has listed out various types of equipment and medical procedures that are offered in a scheme and it is optional for the health insurance cover for the some of the procedures and items as listed under chapter 3 of the guideline.
The regulatory body has also removed certain procedures from its guidelines as stated by the circular. They include hormone replacement therapy, subfertility, infertility, dental treatment that does not require hospitalisation, obesity treatment, stem cell implantation, etc. There is a total of 189 items for which optional cover is provided while 10 delisted procedures were excluded from the list.
30 August 2018
Recently, the Insurance Regulatory Development Authority of India announced that they have set up a 10 member team to standardise health insurance exclusions and make policies a lot more friendly and extend a lot more coverage for various other treatments as well. Now, according to a source, citizens of the country can now avail a health insurance policy for dental treatments, for infertility treatments, HIV and AIDS, replacement therapy, etc. In addition, the IRDAI has also made sure that mental illnesses are included in health insurance policies. Prior to this, none of the aforementioned treatments were included in health insurance and instead were listed in the list of exclusions. The move by the IRDAI to standardise health insurance exclusions amongst all health insurers is also to ensure penetration of health insurance in the country. While the IRDAI is singing all the right tunes with regard to health insurance policies, the Government is on the brink of launching the largest healthcare scheme in the world. Ayushman Bharat as it will be called, or popularly known as ModiCare will offer health insurance coverage for 500 million and each family will get a yearly health insurance sum assurance of Rs.5 lakh.
28 August 2018
Recently, the Insurance Regulatory Development Authority of India announced that they have set up a 10 member team to standardise health insurance exclusions and make policies a lot more friendly and extend a lot more coverage for various other treatments as well. Now, according to a source, citizens of the country can now avail a health insurance policy for dental treatments, for infertility treatments, HIV and AIDS, replacement therapy, etc. In addition, the IRDAI has also made sure that mental illnesses are included in health insurance policies. Prior to this, none of the aforementioned treatments were included in health insurance and instead were listed in the list of exclusions. The move by the IRDAI to standardise health insurance exclusions amongst all health insurers is also to ensure penetration of health insurance in the country. While the IRDAI is singing all the right tunes with regard to health insurance policies, the Government is on the brink of launching the largest healthcare scheme in the world. Ayushman Bharat as it will be called, or popularly known as ModiCare will offer health insurance coverage for 500 million and each family will get a yearly health insurance sum assurance of Rs.5 lakh.
28 August 2018
The Ayushman Uttarakhand Yojna of the state of Uttarakhand has been renamed as Atal Ayushman Uttarakhand Yojana in memory of Atal Bihari Vajpayee, former Prime Minister, who passed away recently. The decision to revise the name of the universal health insurance scheme was taken during the state cabinet meeting conducted on Monday. The spokesperson, Madan Kaushik, announced that the health insurance scheme will cover families eligible for the Pradhan Mantri Jan Arogya Yojana, families already covered under Mukhyamantri Swasthya Bima Yojana, and all state government employees – serving and retired. The health scheme would cover 1,350 different diseases and provide a coverage of Rs.5 lakh per annum. The Atal Ayushman Uttarakhand Yojana will work on a trust model and is currently in the process of adding private hospitals to the network. The 2.6 lakh state government employees who will be covered under the policy will be required to pay a premium towards the scheme. The premium amount payable will depend on the level to which the employee belongs to. The premium ranges from Rs.100 to Rs.400. Pensioners will also be charged Rs.200 under the scheme. However, there will be no limit for the treatments for state government employees.
28 August 2018
Private general insurance firm Reliance General reported a 30% rise in net profit to Rs.57 crore for the first quarter ended June 2018. On a year-over-year basis, the company reported a 23% rise in gross premium to Rs.1,571 crore. Reliance General is the wholly-owned subsidiary of Reliance Capital, and it offers insurance service in various categories including motor, health, home, property, etc.
For the same period, the company’s investment book increased 20% to Rs.8,261 crore compared to the same period of last year. The company also witnessed a significant increase in revenues through its online channels. According to the release, the company has witnessed a 32% increase in gross premiums collected through online channels.
25 August 2018
Out of 250 private hospital in Meerut, only a total of 5 hospitals have applied for the Ayushman Bharat scheme, which popularly known as Modicare. The reason cited by the remaining hospitals is that the rates prescribed by the government for various treatments and procedures were not even half the cost of the actual treatments.
Dr. Raj Kumar Chaudhary, the Chief Medical Officer of Meerut, is expecting the number of applications to rise, given that a meeting was recently held with the district magistrate to persuade hospital owners to apply for the Ayushman Bharat scheme.
24 August 2018
The Insurance Regulatory and Development Authority of India (IRDAI) has instructed insurance firms to submit data on all claims coming from flood-hit regions of Karnataka on a daily basis. Further, insurance firms were instructed to appoint nodal officers in flood-hit areas of the state to expedite the claim settlement process.
Insurers were also asked to provide the contact details of all nodal officers to the IRDAI for more extensive publicity. Maximum insurance claims are expected to be raised by individuals enrolled under the Pradhan Mantri Jeevan Jyoti Bima Yojana scheme, which is available to all holders of Jan Dhan accounts and RuPay cards.
24 August 2018
Private insurer ICICI Lombard became the first non-life insurance company in India to launch Artificial Intelligence (AI) technology in the claim settlement process. The company has pioneered this innovation by harnessing algorithms with the help of various technological systems like Cognitive Computing, Optical Character Recognition (OCR), and Intelligent Character Recognition (ICR).
This is not the first time that insurance companies have used AI technologies in their process. There are many companies in the market that use AI for chatbots and handling simple service requests. However, understanding medical diagnosis and initiating claim settlement is a much more complex activity. The introduction of AI in this process has made it much faster for customers to access their cashless claim service request.
As of now, claim requests take an average of 60 minutes to process. With the introduction of AI, this time is expected to come down drastically in the future. The AI system uses a two-step approach that involves gathering data from the claim documents and evaluating claim admissibility based on the information gathered.
23 August 2018
Private hospitals have threatened to stay away from the Ayushman Bharat- National Health Protection Scheme, as they believe that the plan is not feasible and will not be successful on a long-term basis.
The Indian Medical Association (IMA) has questioned the rates of the medical procedure under this scheme and has called it non-viable, unscientific, and compromisation on patient’s safety according to letter written to NITI Aayog. The prices computed by IMA is 84% higher as compared to the rates fixed by the Government.
IMA felt that the existing rates are 25% lower than what is charged by small and medium hospitals. The association believes that these hospitals will face immense losses if they implement the new rates as per the government-funded health protection plan.
The association has called for a team to be constituted which could fix costs of at least 150 medical procedures. IMA strictly believes that low rates will lead to a decrease in the quality of healthcare as the hospitals would cut down costs to stay away from loses.
22 August 2018
A number of people from Madurai have suffered for more than 10 days after facing problems in enrolling themselves for the State Government Chief Minister’s Comprehensive Health Insurance Scheme (CMCHIS).
The patients who visited the Collectorate premises, the only centre where one can enroll themselves for the scheme have faced only disappointment as they were made to wait for a long period of time and asked to come the other day.
One of the patients who suffer from a nerve-related problem in his eyes has been visiting the centre since 8 August to enroll himself under the scheme only to return disappointed.
A district-level official responsible for the implementation of CMCHIS in his defense said that all the 32 districts in Tamil Nadu were facing enrolment problems due to the upgrade of software which has resulted in the server and network issues.
22 August 2018
In what would be a controversial twist to the grand welcome of what would be the biggest health care scheme in the world, the Delhi Government that is currently run by Arvind Kejriwal is yet to make up their mind whether to join the scheme or not. The scheme, which is labelled as ModiCare is well received by the public, but not all State Governments as well as private hospitals and insurers are for the scheme as there is lack of support financially as well as lack of facilities to meet the demands of the scheme. The Delhi Government is yet to sign a memorandum or understanding with regard to this matter, and might probable give the scheme a miss altogether. State Governments that have come aboard have agreed to bear the cost partially to meet the coverage as set by the Government and in addition, some states have set up Trusts to fund the cost of the facilities. According to the Government, the Ayushman Bharat will cater to the poorest of the poor in the country and 500 million people will be insured under the scheme. Each family under the scheme will get a sum assured of Rs.5 lakh with the Ayushman Bharat.
21 August 2018
ICICI Lombard, a leading general insurance company in India, has recently launched the country’s first artificial intelligence (AI) based technology in order to facilitate instant approval of health insurance claims. With the launch of this technology, the time taken to process traditional cashless health insurance claim requests has been brought down to just a minute from one hour.
It is seen that artificial intelligence is also increasingly being using in the medical field. For example, medical professionals use AI-based technology for a number of medical procedures and treatments including cataract, appendicitis, maternity-related procedures, hysterectomy, and haemodialysis.
21 August 2018
Safecorp Holdings Pvt. Ltd. is an association of Madison Capital, Rakesh Jhunjhunwala, and WestBridge AIF and they recently announced that they will acquire Star Health and Allied Insurance for an undisclosed amount. According to a source, Safecorp Holdings has entered into a definitive agreement with the board of Star Health and Allied Insurance. Sources reveal that the deal value is around Rs.100 crore. The current shareholders of Star Health are Apis Partners, Tata Capital, and ICICI Venture. V. Jagannathan, the CMD of Star Health, stated that the company has reached the stage it is currently in with the combined efforts of the team. The new investors will further boost the success and help the stand-alone insurance company reach new heights. Rakesh Jhunjhunwala, as well as Sumir Chadha, MD and co-founder of WestBridge Capital, are positive about the pace the company will take in the retail health insurance space.
20 August 2018
At the Independence Day function held at Bhubaneswar, CM Naveen Patnaik revealed the all-new medical insurance scheme – Biju Swasthya Kalyan Yojana. The insurance scheme, named after the CM’s father and former CM of Odisha, will offer medical insurance to 70 lakh families. The plan will offer Rs.5 lakh coverage to all families on an annual basis. Women, on the other hand, will receive Rs.7 lakh coverage. The government has already sent out letters to the beneficiaries of the scheme.
CM Patnaik promised that no underprivileged family in Odisha will be denied medical assistance due to lack of funds and hence launched this new scheme. The state government of Odisha has rejected the central health insurance scheme announced by PM Modi which is to be launched on September 25 on grounds that it covers only around 69 lakh families that do not constitute the complete underprivileged section of Odisha.
17 August 2018
The Insurance Regulatory and Development Authority of India (IRDAI) has informed insurance firms to provide coverage for mental illnesses, as well. This notification from the IRDAI came three months after the Mental Healthcare Act, 2017 was put into effect.
The notice sent by the IRDAI on August 16 stated that every insurance firm should make provision for health insurance for the treatment of various mental illnesses. This notice is applicable to all insurance firms in India, effective immediately.
The Mental Healthcare Act, 2017, which came into force earlier this year on May 29 was implemented with the aim of protection of rights of individuals with mental illnesses. As per the National Mental Health Survey of India 2015-16, nearly 15 crore people in the country required interventions for various mental disorders. Families of these individuals had to spend between Rs.1,000 and Rs.1,500 on a monthly basis for the necessary treatment, thus causing them significant financial burden.
17 August 2018
Prime Minister Narendra Modi announced the launch date of the government’s ambitious health insurance programme, Ayushman Bharat, during his Independence Day speech. Mr. Modi stated that the Jan Arogya Abhiyan (the new name for Ayushman Bharat) will be launched on September 25th of this year. This programme aims to provide coverage worth Rs.5 lakh for 50 crore individuals belonging to the low-income segment of the society.
In addition to providing health insurance, this scheme is also expected to open an array of opportunities for people in the country. Following the launch of this scheme, new hospitals are likely to be built in tier-2 and tier-3 cities in the country.
So far, 28 states in the country have signed up for this scheme. Most of these states have opted for the trust-based model, which involves the government disbursing the benefits without the involvement of an insurance company. This scheme was originally announced by Finance Minister Arun Jaitley during the last budget session.
16 August 2018
The Union Health Ministry has estimated that the Ayushman Bharat scheme will create almost 2 lakh job opportunities within 5 years of its implementation. The jobs that are likely to be created will be at various levels such as insurance companies, hospitals, research departments, and call centres.
The National Health Protection Scheme is expected to cover more than 10 crore economically vulnerable families, and provide a health insurance cover of up to Rs. 5 lakh per family on an annual basis for secondary and tertiary care hospitalisation.
Mr. Narendra Modi, the Prime Minister of India, is expected to announce the launch of this scheme on August 15 from the Red Fort.
14 August 2018
With the health care services on the brink of a revolution with the ModiCare as called by the media and the commonly known as the Ayushman Bharat, insurers public and private are doing their best to offer health services to citizens, and in some case, they are offering free health service camps as well. The Ayushman Bharat will be revolutionary as once rolled out, it will cover 500 million citizens in the country and will offer a sum assured of Rs.5 lakh to every family or household. This will make it the largest healthcare service in the world once launched. The Ayushman Bharat will focus on offering healthcare services to the poorest of the poor in the country. Talking about health care services, Apollo Munich, a joint venture between hospital chain Apollo hospitals and global insurers Munich, conducted a free health care checkup for citizens in Bokaro. According to an official, the prime objective of the checkup was to check the diet, health situation and offer tips on weight control. Based on the checkups, officials of Apollo Munich said that a vast proportion of the attendees suffered from diabetes, especially the men and most of the citizens were either underweight or overweight.
13 August 2018
With a number of states in the country and private insurers as well as hospitals objecting to the scheme, due to the cost of as well as lack of facilities, the Punjab Government has to come to an agreement with the center and said that it will support the Ayushman Bharat scheme which is labelled as ModiCare. According to the Punjab government, they have come to an agreement with the central government and will extend the benefits of the scheme to 50 lakh families in the state hailing from the poorest of the poor. The scheme will cost Rs.500 crore and the center according to the Punjab State Government has agreed to forward Rs.90 crore and the remaining amount will be borne by the state. The scheme will give each family a sum assured of Rs.5 lakh per year in case of hospitalisation or illness. Like many other states, the Punjab state government initially disagreed to be a part of the National Health scheme but circumvented its decision and has now agreed to be a part of it in order to benefit its citizens. States across the country have even set up Trusts to meet the costs of the scheme.
11 August 2018
The state of Maharashtra has a health scheme by the name Mahatma Jyotiba Phule Jan Arogya Yojna (MJPJAY) and the state government recently dropped 5 Nagpur hospitals from the scheme. The hospitals are alleged to have been involved in certain malpractices. According to the scheme, the hospitals receive a reimbursement of the expenses incurred in treating a member of the scheme. However, the hospitals have been alleged to have collected the fees from the patients as well as received a sum of money from the government. The hospitals, on the other hand, deny all such claims and state that they were not given an opportunity to explain themselves.
11 August 2018
The Council for Indian School Certificate Examinations (CISCE) has asked all schools associated to the board to insure all the students, with focus on the students who are going to participate in the 64th national school games this year. In India, there are more than 2,000 schools and the number of students in total is over Rs.25 lakh. If the plan is implemented, this will be one of the largest universal insurance coverage plans. CISCE has further advised schools to provide a combination of health insurance, travel insurance, and accident insurance with a coverage of Rs.1 lakh. The Council Secretary, Gerry Arathoon, believes that the insurance cover will not only provide coverage for students during the national games event but also for sports events in school as well as everyday commute. The idea of the insurance cover is to reduce the financial burden that parents may have to endure in case a student faces a mishap. However, a few school officials are not happy with the idea and are unsure of how parents would react to a hike in school fees due to the insurance premium payment.
10 August 2018
The ambitious national health insurance scheme aims to offer Rs.5 lakh coverage to about 50 crore financially deprived citizens of the country. PM Modi, in his recent address, asked the officials to make sure that the scheme has no loopholes that could possibly lead to fraud. He emphasised the fact that any such flaws will be inflated since the elections are around the corner. The logo for Ayushman Bharat, for which Modi has given suggestions, will be unveiled soon. Modi also asked the officials to ensure that all empanelled hospitals maintain cleanliness and good hygiene. Ayushman Bharat is going to be launched on 15 August 2018. So far, 26 states have signed MoUs with the Centre to implement the scheme. Also, around 6,000 hospitals have been empanelled to provide facilities.
9 August 2018
The State Government of Maharashtra is likely to sign an MoU with the Centre, ahead of implementing the National Health Protection Scheme (NHPS) across the state. Once implemented, the NHPS will benefit more than 83 lakh people residing in the state. The state of Maharashtra will, however, not be one of the first 10 states to implement the scheme.
Given that certain authorities from the state have said that implementing the scheme will cause a financial burden on the state, the State Government of Maharashtra is now trying to assess if it can implement a trust model or a hybrid insurance model for the beneficiaries of the scheme.
8 August 2018
Private insurance firm Bajaj Allianz General Insurance has entered into an agreement with Vijaya Bank to offer insurance products to the bank’s customers. Under this bancassurance deal, Vijaya Bank will provide distribution service for various products offered by Bajaj Allianz through its 2,129 branches located all over the country.
This tie-up allows Bajaj Allianz General Insurance to sell insurance products in various categories including motor, health, personal accident, home, and travel to customers of Vijaya Bank. This deal is likely to help Bajaj Allianz increase its customer base in South India as Vijaya Bank has a strong presence in this region.
According to Mr. Shankara Narayanan, MD and CEO of Vijaya Bank, deposits and loans will remain the main products of the bank. However, customers will now have the option of choosing general insurance products from the bank.
8 August 2018
Ayushman Bharat, the ambitious health scheme that is to be implemented throughout the nation, is expected to create a minimum of 10,000 job opportunities in the country. Each hospital that is empanelled with the government to provide the facilities offered under the National Health Protection Scheme (NHPS) will have an official called the ‘Ayushman Mitra’. The official will coordinate between the hospital and the beneficiaries of the scheme. The hospital will have a help desk where people can approach the Ayushman Mitra. The Ayushman Mitra will verify the documents submitted to check whether the individual is eligible to be enrolled into the scheme or not. While only 20,000 public and private hospitals have been empanelled, around 1 lakh Ayushman Mitras are expected to be appointed. The Ministry of Health has given the responsibility of recruitment of the Ayushman Mitras to the Skill Development Ministry.
7 August 2018
The Prime Minister of India, Mr. Narendra Modi, has asked officials to incorporate strong measures to prevent fraud and misuse in the government’s ambitious Ayushman Bharat scheme. Coming days ahead of its official launch, this announcement asks officials to ensure that this scheme is not affected by any fraud as even the smallest slips will be highlighted during the upcoming election season.
In the first phase of its implementation, the Ayushman Bharat scheme (popularly known as ‘Modicare’) will be launched in 12 states on August 15th. This first phase is expected to be completed by October 2nd.
The Prime Minister has also asked health ministry officials to take extra care in assuring the cleanliness and hygiene of hospitals empanelled under this scheme. This ambitious program aims to cover more than 50 crore members belonging to 10 crore underprivileged families in different parts of the country. Under this scheme, each family will have coverage worth Rs.5 lakh on a family floater basis.
6 August 2018
The Quality Council of India will conduct a programme in Varanasi on August 9 in order to brief the residents of the city about the Ayushman Bharat Scheme. The scheme is scheduled to be launched on independence day this year.
The programme will see the CM of Uttar Pradesh, Yogi Adityanath take part in it. Varanasi is the constituency of prime minister Narendra Modi.
The programme will focus on four areas, namely on how to make the scheme quality centric, improvement of primary health centres, the role of health assurance vis-à-vis health insurance, and the creation a strong feedback system. The state has around 3 crore individuals who will be beneficiaries of the scheme.
4 August 2018
Aligning with the Government of India’s digitisation drive, Future Generali has launched its very own mobile app called “FG Insure” which will be available to customers from August 1, 2018 onwards. Using the app, customers can subscribe to insurance plans, upload their documents for the procedure, choose a health care program, calculate the premiums of the policy and lots more than would improve the insurers customer service immensely. Commenting on the launch of the app, K. G. Krishnamoorthy Rao, Managing Director and CEO – Future Generali India Insurance Company Limited, said that the country is currently embracing the digital wave and hence we at FGII we are focusing on making significant strides to provide innovative solutions that enhance the convenience of our customers. ‘FG Insure’ empowers the customer by allowing him to update his information, manage, buy and renew policies, initiate claims and update policy related non-financial information. One of the highlights of the app is that customers can get medical advice from doctors of their choice on the app it self and can also connect to insurance experts in order to choose an insurance product that would suit their financial needs and secure their future.
3 August 2018
In what would be the biggest healthcare service in the world, the Modi-Care as labelled by the media and rolled out as Ayushman Bharat by the Government is all set to be launched on August 15, 2018. The healthcare service will be extended to 500 million individuals from the poorest of the poor in the country and each family will be insured for Rs.5 lakh annually. In order to aid the Government set this up with haste, States across the country have set up non-profit trusts to collect money that will directed as subsidies for the poor. This will help the Government of India reach its goal in no time. According to a source, 20 states plus Union territories will set up the trusts to help the poor receive healthcare across the country. While it seems like all is going smooth sailing for the Government, the lack of private hospitals or insurers signing up to the healthcare service is currently the biggest concern. According to them, the healthcare service is not feasible and there is a dearth of facilities to meet the demands as set by the Government of India.
3 August 2018
While the Employee State Insurance Corporation (ESIC) does its part every single day to improve the lives of state employees in the country by offering its healthcare services to more than 20 lakh Government and state employees in the country, and currently being regarded as the world’s largest healthcare service in the world, the Employee State Insurance Corporation (ESIC) was in awe of the work of the ISKCON Food Relief Foundation (IFRF). The ISKCON Food Relief Foundation (IFRF) selflessly provides food for more than 2.5 lakh children everyday for free who are from more than 2 thousand schools. The ISKCON Food Relief Foundation (IFRF) believes that their work will make children start to dream of being something in life and also are sticklers of providing hygienic food to more than Rs.2.5 lakh children. Commenting on the work of ISKCON Food Relief Foundation (IFRF), members of the Employee State Insurance Corporation (ESIC) said their word is the best example of Community Participation and how such organisations can serve to the community, since not just god, they are serving the humanity as well. The members concluded by saying that they just have praise for IFRF dedication and hard work. It is our privilege to keep these wonderful workers fit and healthy by organising such camps regularly.
2 August 2018
With the number of claims related to health ailments and other digestive diseases increasing by almost 94% over the last year, top insurance companies in the country ran tests at workplaces to determine the health situation of customers and put a finger on as to why such employees are falling sick so often. The tests were initiated after a steel company employee dropped dead due to a heart attack. Following the workplace test, ICICI Lombard executives said that they carried out audits of workplaces and found that the particulate matter was high and oxygen levels poor, leading to higher instance of respiratory and heart-related ailments. The company added saying that they propose certain changes in the office upkeep and ventilation in such instances. In addition, certain other tests were carried out by insurers to check the food quality, ventilation and other aspects of a workplace which might contribute to the slump of a person’s health. Following their study, they said that their analysis of claim trends shows that over 8 percent of employee claims are from digestive disorders, and the average claim in this disease category is around Rs 42,000.
1 August 2018
The Insurance Regulatory and Development Authority of India (IRDAI) had set up a working group to study the innovations in the Indian insurance industry with regard to portable and wearable devices. The group has now come out with certain recommendations for insurance companies to offer discounted premium rates to customers on the basis of their activities and habits.
Insurance companies are also of the view that wearables will help them assess risk better and play a significant role in the underwriting process, especially for health and life insurance products. With regard to motor insurance, insurance companies can use IoT devices and telematics to track the driving habits of customers, and thus arrive at an accurate level of risk and premium rate.
The 10-member committee that was put together by the IRDAI included officials from New India Assurance, Life Insurance Corporation of India (LIC), Max Bupa, Bajaj Allianz General Insurance, and ICICI Prudential Life Insurance.
1 August 2018
The first list of the Ayushman Bharat project saw around 6.5 million beneficiaries being untraceable according to the National Health Agency.
Considering an estimated average of five members per family, the missing of such numbers mean that close to 33 million people stand the risk of not getting the benefits under the Ayushman Bharat scheme. The scheme, also known as ‘Modicare’ was going to be launched on 15 August 2018.
Families who belong to the lower strata of the society and are considered to be economically weaker would receive up to Rs.5 lakh as the annual hospitalisation cover.
The people who are currently untraceable were living in a particular locality as per the 2011 census and since then has changed bases which have resulted in the government unable to trace them.
Uttar Pradesh followed by Bihar has the largest number of missing people with 2.36 million and 2.17 million people respectively. The other states together have a total of 1.94 million people who currently cannot be traced. Migration has been touted as the biggest reason for such a huge number of people missing from the list. Indu Bhusan, the CEO of Ayushman Bharat has called for the people to come forward and identify themselves so that they can enjoy the benefits provided by the scheme.
Apart from providing health cover to economically backward people enrolled under the scheme, the plan will also provide cover to those families getting benefits under the Rashtriya Swasthya Beema Yojana. Those who are yet to enroll under the Ayushman Project or have missed out during the beneficiary identification scheme will find it difficult to receive the benefits under the upcoming government health policy. The experts believe that it will be difficult to provide 100% coverage to all the targeted beneficiaries.
1 August 2018
The number of fraudulent health insurance claim has grown in the city of Hyderabad with Goodlife Hospital in Kothapet having already filed six insurance claim, all of them being related to fever, urinary tract infection, and gastroenteritis and having a claim worth Rs.1 lakh.
An investigating officer suspecting fraud visited the residence of one of the patients and found out that he was a doctor employed at the same hospital and the signature on the document was forged.
The officer also investigated another patient to find out that she had fabricated a false address and had not undergone any treatment whatsoever at the Goodlife Hospital. The insurance company in return filed a case against the hospital.
It was found that close to 45% of claim submitted was of a fraudulent nature and often the doctors and hospital staff were involved. They often listed the outpatient as inpatient and replaced the genuine details of the patient with fake claims.
One of the claimants who was involved in the fraudulent process produced a medical certificate from a doctor who had died a long time ago. A visit to the claimant’s house revealed that her husband who runs a medical store was the mastermind behind the fraud and prepared the case sheets for the hospital in order to avail the benefits.
Most of the corruption is detected during the reimbursement process. Many claims despite not being treated would claim insurance as and when the policy was about to get expired. They would pay the hospitals a percentage of the claim in order to get fake bills and raise claims for themselves.
A hospital despite getting blacklisted are able to move to other cities and operate with a different bunch of people. The final step is to file a police case under Section 420 of IPC. The various insurance company in order to check fraudulent activities have started hiring private investigators.
31 July 2018
The general insurance company, New India Assurance posted a 27% rise in its year-on- year (y-o-y) profits for the first quarter which ended June 30 due to growth in its gross premium. The insurer made a profit of Rs.635 crore as compared to Rs.499 crore it made during this period last year.
The insurance company saw its gross direct premium rise by 12.6% y-o-y to end at Rs.6,053 crore. The global written premium rose 10% y-o-y to end at Rs.6,961 crore.
The combined ratio for the current first quarter was flat at 111.02% as compared to 111.03% last year. The adjusted combined ratio, however, dropped from 95.32% last year to 94.72% for the first quarter.
The annualised return on equity was at 16.1%, while the solvency margin was 2.66 with the regulatory requirement being 1.50.
31 July 2018
Uttar Pradesh, on 29 May 2018, had decided to implement the National Health Protection Scheme (NHPS) with the insurance model wherein the state government floats tenders and the insurance company that bids the lowest premium amount is chosen. However, the UP state government changed its mind and decided to take up the trust model instead. Under the trust model, the state government will act as the insurance company and the citizens can enjoy the benefits provided by the scheme from the hospitals empanelled with the state government.
Over twenty states and union territories have signed MoUs to implement the NHPS. While states such as Assam, Bihar, Madhya Pradesh and Uttar Pradesh have opted for the trust-based model, states like Gujarat are going to use a combination of both the models. The central government had provided both the options to state governments.
31 July 2018
With India on the brink of rolling out the largest health care scheme in the world, called Ayushman Bharat and labelled ModiCare by the media after Obama Care, the Tamil Nadu Government is busy doing its bid to help their citizens. The Ayushman Bharat scheme is offering Rs.5 lakh for individuals for a year and this health insurance cover will benefit 500 million people in the long run. The Tamil Nadu Government just a few days back announced that they would be increasing their health insurance coverage from Rs.2 lakh to Rs.4 lakh in view of the National Health scheme. The offer which is inclusive of cashback benefits as well will benefit more than 7 lakh Government pensioners. However, the premium which is usually redirected from their pension account will increase from Rs.150 per year to Rs.300 per year and according to sources, pensioners have no qualms about the hike in premiums. According to N L Sridharan, president of TN All Dept Govt Pensioners Association, we have two requests to the government in the new scheme don’t allow the insurance firm to rope in a third party administrator to bring in more transparency in terms on hospital bills and reduce the monthly premium.
29 July 2018
With India on the brink of rolling out the largest health care scheme in the world, called Ayushman Bharat and labelled ModiCare by the media after Obama Care, the Tamil Nadu Government is busy doing its bid to help their citizens. The Ayushman Bharat scheme is offering Rs.5 lakh for individuals for a year and this health insurance cover will benefit 500 million people in the long run. The Tamil Nadu Government just a few days back announced that they would be increasing their health insurance coverage from Rs.2 lakh to Rs.4 lakh in view of the National Health scheme. The offer which is inclusive of cashback benefits as well will benefit more than 7 lakh Government pensioners. However, the premium which is usually redirected from their pension account will increase from Rs.150 per year to Rs.300 per year and according to sources, pensioners have no qualms about the hike in premiums. According to N L Sridharan, president of TN All Dept Govt Pensioners Association, we have two requests to the government in the new scheme don’t allow the insurance firm to rope in a third party administrator to bring in more transparency in terms on hospital bills and reduce the monthly premium.
29 July 2018
The implementation of Meghalaya Health Insurance Scheme (MHIS) has been approved by the Meghalaya cabinet and has permitted to merge the MHIS - IV with Central Government’s health protection program - Ayushman Bharat Scheme.
Post the meeting chaired by the chief minister of Meghalaya Conrad Sangma, the health minister of the state Al Hek said that the MHIS - IV has been approved and will provide a health coverage of Rs.5 lakh for each household on a yearly basis.
Heck said that the scheme will cover all the people of Meghalaya except for the government employees and will also cover the cost of various tests as well.
27 July 2018
The Chief Minister of Arunachal Pradesh recently launched the Chief Minister’s Arogya Arunachal Yojana (CMAAY) in the state. This health insurance scheme is aimed at providing cashless hospitalisation in network hospitals. The scheme uses a software program for the same. MD India has developed the software and will look after its implementation.
CMAAY is a replacement for the CM’s Universal Health Insurance Scheme which was previously in force. The state government aims to provide healthcare facilities to the entire population of the state by the year 2020. While this was the soft launch of the scheme, a full-fledged launch is expected soon. Under the scheme, each family covered will be eligible for health services to the tune of Rs.5 lakh each year.
The Chief Minister stated that the success of the scheme would depend on its implementation. He also asked all officials involved to adhere to the deadlines to implement the scheme. The full-fledged launch of the scheme is scheduled to be on Independence Day this year.
27 July 2018
Beginning August 1, all individuals who have enrolled for free surgeries under the Mahatma Jyotiba Phule Jan Arogya Yojana (MP JAY), will receive a minute-long pre-recorded phone call from Mr. Devendra Fadnavis, the Chief Minister of Maharashtra, informing them about the various facilities that are available under the scheme and the duties that are expected of the treating hospitals.
This move is expected to raise awareness among individuals who undergo cashless treatments at empanelled hospitals and to reduce any risk of malpractice among the empanelled hospitals. Under the MPJAY scheme, hospital accommodation, food, consumables, medicines, and treatment is provided free-of-cost to individuals who are below the poverty line.
Individuals will receive the recorded phone call as soon as their enrolment is completed. The State Government of Maharashtra has also started to issue inland letter cards to all patients from June 7 onwards. These inland letters ask patients a number of questions with regard to the hospital service, additional cost incurred, etc. in order to gauge the patients’ feedback of the insurance scheme.
26 July 2018
The Insurance Regulatory and Development Authority of India (IRDAI) has formed a group that will work on standardising the exclusions of health insurance agreements. The chairman of the group will be the Executive Director of IRDAI, Suresh Mathur. The group has 10 members and they will go through the exclusions of health insurance policies and analyse which exclusion can be allowed and which cannot. The IRDAI stated that the exclusions laid down by the insurers need to be rationalised and that certain exclusions that restrict the coverage offered by the insurer should not be included. The group will also study the language and terms used in the exclusions so that they can be standardised later to simple words. The regulator wishes to adopt a uniform approach for the exclusions and the wordings used under the policy.
26 July 2018
With the penetration of health insurance in the country increasing by the day, the Insurance Regulatory Development Authority of India has directed insurers across the country to minimize the exclusion list of health problems and offer more transparency to the policyholders with this regard. With a number of insurers in the country offering health policies with a long list of exclusion list ranging from a list of diseases and illnesses and consequences leading to hospitalisation, the IRDAI has asked insurers to include only those illnesses and diseases that covered and increase the overall coverage for the benefit of health insurance policyholders across the country. In addition, the IRDAI has asked insurers to standardise their regulations and guidelines and bring about some uniformity and transparency for their customers. Based on a statement by the insurance body, insurers have to rationalise the exclusions that disallow coverage with respect to new modalities of treatments and technologically advanced medical treatments. Identify the type of exclusions which shall not be allowed. For this, the IRDAI has set up a 10 member panel who have to submit a report in the matter within 2 months.
26 July 2018
The Insurance Regulatory and Development Authority of India (IRDAI) recently said that it has started the process to reduce the number of exclusions under health insurance policies. For this purpose, the insurance regulator has established a 10-member committee to examine the issue.
The committee will examine the various exclusions that are currently prevalent in health insurance plans with a view to reduce this number and increase the scope of coverage. The group is expected to submit its suggestions and recommendations about the same in 8 weeks. The committee will also study the language and wordings of the exclusions, and will standardise the wordings to make it more comprehensible.
26 July 2018
The Maharashtra Government has de-empanelled as many as 27 hospitals from its health insurance scheme Mahatma Jyotiba Phule Jan Arogya Yojana (MJPJAY) in a single meeting. This represents the highest number of de-empanelment ever since the scheme was launched in 2012. Officials cite various reasons like hospitals charging money from patients, manipulation of records, and low performance for this action.
Among the hospitals de-empanelled, four are located in Aurangabad, three are from Nashik, three are from Nagpur, two are from Pune, and one is from Mumbai. Other hospitals are located in different parts of the state including Akola, Ahmadnagar, Thane, Amravati, Solapur, Palghar, etc.
Dr. Sudhakar Shinde, Chief Operating Officer of MJPJAY, noted that the government issued notices to these hospitals de-empanelling them. Some of these hospitals were suspended earlier and given a second chance to improve. The committee took this action after receiving regular complaints against these hospitals.
The MJPJAY scheme provides coverage for more than 2.25 crore people in the state. This scheme coverage about 971 procedures and offers a maximum sum insured amount of Rs.1.5 lakh.
25 July 2018
In order to save a number of lives and to half illegal trafficking of organs in the country, the Minister of women and child development, Maneka Gandhi has urged the government to step up its measures to improve the number of organ donors in the country. According to Gandhi, in order to make sure people come forward to be donors, life insurance companies should offer premium discounts for their policies if they agree to be a donor. Gandhi does feel that this might be a scary though for families to be donors, but even if 10% of the population are donors, then lakhs of lives will be saved in the future. Gandhi added that the government should mandatorily add a clause stating that in case of the death of the patient in the hospital whether he/she would like the organs to be harvested for the purpose of giving a new life to other patients. Gandhi stresses on the fact that the government has to improve facilities with regard to organ transplants. She said, India has very limited availability of organs for transplanting which is limited to cadaver harvesting and a minuscule voluntary donation. Even in the case of voluntary donation it is generally the woman of the family - wife, sister, mother who is forced to donate her kidney or liver to the man in the family.
25 July 2018
The Vice President of India, M. Venkaiah Naidu, inaugurated the centenary celebrations of New India Assurance Co. Ltd. He addressed the people gathered for the event and stressed on the need for the insurance industry of India to develop and help the country grow by introducing innovative products with varying features. He urged New India Assurance to make India fully insured as soon as possible. He also said that insurance companies need to offer better and more advanced schemes that people can avail to safeguard their health, motor vehicles, machinery, shops, cattle, etc. He is of the opinion that the insurance industry can help the economy of the country grow and can create many job opportunities.
New India Assurance Co. Ltd. recorded a gross written premium of Rs.26,554 crore in the FY 2017-18 and a growth of 16 per cent. The company has a market share equal to 15% of India’s insurance business. The claim settlement ratio, one of the key features of a company, was 97.32% for the FY2017-18 for New India Assurance Co. Ltd.
25 July 2018
General Insurance Company, ICICI Lombard, recorded an 11% growth from Rs.1,174 crore in June 2017 to Rs.1,309 crore in June 2018. Also, the business for April-June 2018 is equal to a whopping Rs.3,774 crore which indicates a growth of 14%. The market share of the company is 10.10%. With respect to private general insurance companies, ICICI Lombard is followed by Bajaj Allianz and HDFC Ergo which have market shares equal to 6.47% and 4.53% respectively.
ICICI Lombard is the first private insurance company to have outrun United India Insurance, which has a market share of 9.67% and has witnessed an income of Rs.3,611 crore in the April-June 2018 period. The general insurer that has topped the overall list is New India Insurance, which has recorded a business of Rs.6,283 crore during the same period.
24 July 2018
The state government of Odisha recently announced that it will be enrolling all the families who have opted for the RSBY and BKKY schemes under one uniform health insurance system. Families enrolled under the new platform will be provided health coverage for Rs.1 lakh with an additional sum insured of Rs.4 lakh from the Odisha State Treatment Fund.
This decision to unify the two schemes into one platform was taken at a recent cabinet meeting that was chaired by Mr. Naveen Patnaik, the chief minister of the state.
24 July 2018
For the quarter that ended on 30 June 2018, the total premium collected by general insurance companies went up by 12.2% to Rs.37,349.40 crore. The New India Assurance Co. Ltd. collected the maximum amount of premiums equal to Rs.6,283.09 crore. The company was followed by United India Insurance Co. Ltd. that collected Rs.3,611.31 crore. The total premium amount collected by private health insurance companies, according to the Insurance Regulatory and Development Authority of India (IRDAI), grew by 36.31% to Rs.1,977.84 crore during the quarter. The total premium collection of all insurance companies put together – public and private during the month of June 2018 is Rs.12,974.50 against the total premium collection for the previous fiscal years which was Rs.11,495.83 crore.
23 July 2018
A recent study done by the Public Health Foundation of India (PHFI) revealed that 55 million Indians were driven into poverty in 2017, as a result of out-of-pocket medical costs. The results of the new study were disclosed on 6 June, 2018. The PHFI used the reports published by the erstwhile Planning Commission in 2013 and National Sample Survey as the primary and secondary sources of data. In addition to these, data from other sources were also used to arrive at the results.
22 July 2018
Ayushman Pakhwaras, a public contact programme by the Government of India is being organised in order to ensure that the Ayushman Bharat health insurance scheme is implemented in a successful manner. The programme will ensure that the Ayushman Cards are successfully delivered to more than 11 crore families who have enrolled themselves under the health insurance scheme.
According to the CEO of Ayushman Bharat - National Health Protection Mission said that the government is expected to complete all the preparations related to the Ayushman Bharat scheme by August 15.
A customer care service centre equipped with email services and online chat will be set up in Delhi which will look into the complaints and queries from the people.
21 July 2018
The State Government of Meghalaya is most likely to increase the health insurance cover from Rs.2.8 lakh to Rs.5 lakh under its Megha Health Insurance Scheme (MHIS).
Al Hek, the health minister of the state who inaugurated the Laiktor Health Sub centre in Shillong stated the news regarding the Government’s alleged consideration to hike the health insurance cover.
Hek asked the people to enroll themselves under MHIS and save on hospitalisation charges and other ‘out of pocket’ expenses. He also said that the Meghalaya Government is mulling to inaugurate a state- of - the - art diagnostic centre in Shillong for which the Pasteur Institute in the capital city has been identified as one of the two places for the project.
Hek said that the Meghalaya Government led by Conrad Sangma is committed to providing health insurance cover including quality health care services to all the section of the society, and more especially to the people who belong to the economically weaker section.
19 July 2018
The premium for the ambitious National Health Protection Scheme (NHPS) launched by the government this year will vary from state to state. The contribution of the state and central governments will be in the 60:40 ratio. The states will launch tenders and the insurance company that bids the lowest insurance premium will be chosen. Chandigarh is the first Indian state to have initiated the tender. The tender will be from 15 August 2018 to 14 August 2019. The other Indian states are expected to initiate tenders in the next 2 or 3 weeks. The premium amount will depend on the tender conditions and the number of people that are going to be covered under the scheme. The NHPS, also known as Ayushman Bharat, will cover 11 crore underprivileged families which means approximately 50 crore people will benefit from the health scheme. The coverage amount for each family is Rs.5 lakh per family.
19 July 2018
According to a data released by National Sample Survey Report (71st round), around 92.7% of the population in Jammu and Kashmir do not have health insurance.
The experts believe that a majority of residents of J&K would not have to spend an insurmountable amount on health had the Government of India rolled out the Rashtriya Swastha Bima Yojana in the state.
The scheme was introduced in 2008 and was in operation in 20 states in India. It took care of financial problems arising out of various health issues and helped the people belonging to the lower strata of the society. Jammu and Kashmir were one of the few states where the scheme was limited only to papers for close to ten years.
18 July 2018
A prominent health insurance firm was fined Rs. 50,000 for rejecting a genuine claim. The District Consumer Disputes Redressal Forum had passed the verdict against the insurance firm. The forum also directed the firm to pay the respective claim amount of Rs 1.17 lakh along with the interest at the rate of 9%, starting from the date of claim rejection, 4 April, 2015. The health policy in concern was assured for a total sum of Rs.5 lakh.
18 July 2018
The Niti Aayog, in a bid to improve the existing public healthcare system in the country has proposed the establishing of a digital healthcare system termed the National Health Stack. If implemented, the system can be used by various entities, including the states and the centre.
The aim is to have a health record of everyone in the country over the next four years, thereby giving a boost to the health schemes promoted by the government.
The government had, in the budget, announced the launch of Ayushman Bharat, a scheme under which 10 crore families are to get a cover of Rs.5 lakh each.Implementation of the National Health Stack will require the creation of digital health identification, on the lines of Aadhar. The system is likely to use APIs or open application programme interfaces to store the records.
17 July 2018
OPPI (Organisation of Pharmaceutical Producers of India) recently organised its annual summit in New Delhi, where it launched a new digital campaign #ThinkForHealth. The campaign aims to generate new ideas to ensure that people have better access to health services for issues ranging from mental health, women and child health, NCDs, etc. OPPI has partnered with the Govt. of Telangana for this project, with the state providing support to ideas generated on the platform.
OPPI collaborated with the Ministry of Health and Family Welfare, the Ministry of Chemicals and Fertilisers and invest India to organise its annual summit.
The campaign aims to provide stakeholders an opportunity to showcase initiatives to help improve the existing healthcare infrastructure in the country.
17 July 2018
With the Aadhaar card being a heated debate between the Supreme Court and the Government of India over the last few months, whether it should be made mandatory for services, insurance and so on, the Supreme court has frequently overruled the Center’s wish to make it mandatory for all fields. However, with the biggest health care service all set to be launched in the country, labelled ‘ModiCare’ by the media and officially called the Ayushman Bharat health insurance scheme, the National Health Agency confirmed that the provision of Aadhaar card will not be a necessity for citizens to avail the services of the health insurance scheme. The rumor of making the provision of one’s Aadhaar card to avail services of the Ayushman Bharat health insurance scheme was squished by the Central Government, who confirmed that the provision of Aadhaar card will not be a necessity for one to avail coverage and services listed under the to-be largest health scheme in the world. The Ayushman Bharat health insurance scheme which was scheduled to be launched on August 15, 2018, by the Prime Minister of the country might be delayed as though the offer seems promising for the poorest of the poor, the lack of facilities and cooperation from health insurers seems to be a hurdle right now.
14 July 2018
The per capita expenditure proposed by the government for the national health insurance scheme, Ayushman Bharat, is much lower than the per capita spends for the Employees’ State Insurance Scheme (ESIS). According to a report by the National Health Profile, the per capita expenditure for the ESI scheme in the year 2017 was Rs.505 indicating the per family expenditure of the scheme to be Rs.2,525, assuming the number of members in the family to be five. The per family spends for Ayushman Bharat national health insurance scheme, on the other hand, is Rs.1,082 indicating the per capita expenditure to be Rs.216. Ayushman Bharat is to provide a Rs.5 lakh medical cover to every family on a yearly basis. The scheme will cover the socially and economically backward classes of the society. As of 14 June 2018, 20 states had signed MoUs for the national health insurance scheme.
12 July 2018
As with most other countries in the world, India too has a huge proportion of its population that are suffering from stress - be it physical or mental. The daily lives of individuals puts them under pressure and the lack of financial stability is another prime factor as noted that is contributing towards this stat. According to a survey released by Cigna TTK health insurers, apparently 89% of Indians suffer from stress - physical as well as mental stress. According to the insurer who compiled the report, despite the staggering numbers, 75% of Indians do not seek professional help to help them find a way to beat stress. According to them, have professional help will only help the person overcome their stress levels as soon as they point out the impetus of the problem. Above the global average of 86% of the number of people suffering from stress related disorders, India records 89% of its own population but only one in 8 patients seek professional help to deal with their problems. According to medical experts, stress levels if not managed will lead to a number of health complications in the long run.
12 July 2018
A recent survey conducted by CignaTTK Health Insurance shows that 89% of the Indian population suffers from stress. The survey also shows work and financial issues as key factors contributing to stress. According to the Cigna 360° Well-Being Survey, Indian population suffer from significant levels of stress when compared to other developed and developing countries across the globe.
The survey report also shows that 1 in 8 people find it difficult to deal with their stress, while majority of the respondents are uncomfortable to even open up to a medical professional about their stress.
The survey results were drawn based on the 14,467 online interviews taken between February to March 2018. These interviews were conducted across 23 countries across the globe.
11 July 2018
Nobel prize winning economist Amartya Sen has stated that public health insurance is the need of the hour. He stated that the health sector in India was privatized prematurely, and it is now necessary to shift back to public health insurance in a bid to eliminate corruption. Sen stated this while speaking at a symposium at ICCR.
Sen also noted that India must follow China’s example of how a country could benefit from public health insurance. In his statement, he pointed out that China’s health insurance coverage dipped from 100% to 12% after the introduction of private health insurance. However, it shot back to 88% after public health insurance was introduced again.
According to Sen, a lot of ordinary people in India went bankrupt after incurring huge medical expenses at some point in their life. Sen also spoke about the social issues surrounding the health sector in India. For instance, inequality in the society generates a lot of health issues such as smoking, drinking, lack of physical fitness, etc.
10 July 2018
Reports reveal that Rajasthan and Maharashtra are looking to merge their existing state health insurance schemes with Ayushman Bharat, an ambitious insurance scheme launched by the Modi government. Rajasthan currently has the Bhamashah Health Insurance Scheme, that was launched in the year 2015 that provides health coverage to 92 lakh families. The families enjoy benefits equal to Rs.3 lakh for critical illnesses and Rs.30,000 for common diseases. Maharashtra, on the other hand, has the Mahatma Jyotiba Phule Jan Arogya Yojana, launched in the year 2012, offers health insurance coverage equal to Rs.1.5 lakh to 2.24 crore families. The two states, at present, are reviewing the financial and operational consequences of merging their state plans with Ayushman Bharat. They wish to ensure efficiency of processes and non-disruption of services. The Ayushman Bharat scheme aims to provide Rs.5 lakh health insurance to 10 crore families.
9 July 2018
While the Government of India is on the brink of rolling out the largest healthcare service in the world, in which 500 million people from the poorest background will be insured up to Rs,5 lakh per year, HDFC Bank has been doing its part to raise awareness with regard to health insurance. The ad campaign which is labelled ‘liar mirror’ features Actor/Model Lisa Ray and Actor/Comedian Suresh Menon. Both the personalities have struggled with critical illnesses and are using their fame to spread awareness on the need of health insurance as they opine that the mirror is just a liar and not a reflection of the health of the individual. Commenting on the campaign, Pankaj Gupta said that in India, we have become conscious of our diet and exercise regimen, but still have deep inertia when it comes to regular health check-ups. Non-communicable diseases are on the rise and we wanted to address this increasingly serious social issue, in the most realistic way. Hence, we used the testimonial approach and are delighted to be associated with Lisa & Suresh on this campaign. They are real fighters who have survived their respective challenges and emerged victorious, thereby resonating with our brand message of ‘Sar Uthake Jiyo’. We urge people to not just believe what they see in the mirror, but also delve deeper and be #Ready2Fight.
7 July 2018
A formal process was launched by the National Health Agency to empanel both public and private hospitals to implement the government health insurance scheme.
The move comes amid concerns that not many corporate hospitals are interested in getting empanelled due to low package rates which has made the government worry about a possible drop in quality.
Indu Bhushan, the CEO of the agency under the Union health and family welfare ministry has urged all the healthcare service providers and hospitals to come under the Ayushman Bharat and provide service to those who need it the most.
Ayushman Bharat National Health Protection scheme is an upcoming government health insurance scheme which would provide Rs.5 lakh each as health insurance coverage to 40 crore people in India.
6 July 2018
A recent study conducted by the University of Oxford and George Institute for Global Health revealed that offering cost-free healthcare services to women will not contribute in gender equality. The results were based on the study analysis of more than 19 million households in India. Hospitalisation records between 2008-2012 in Andhra Pradesh collected for the study showed the number of women hospitalised were lower than the number of men hospitalised during the period.
As per the study, offering free healthcare services alone will not benefit women in terms of gender equality. Instead, some other factors that act as barriers, such as prioritising the health of a man over women, prioritising the health of the husband and kids over the women of the houshold, etc., should be considered to make gender equality a reality.
6 July 2018
In what could significantly increase the penetration of health insurance in the country, the Government of India is all set to roll out the largest health care scheme branded as ModiCare by the media but called the Ayushman Bharat health insurance scheme. Expected to be launched on August 15, 2018, the healthcare scheme which is expected to rival and topple Obama Care is going to service 500 million individuals from the poorest of families in India. With each individual set to be assigned a sum assured of Rs.5 lakh every year, this scheme which is still in its setting up phase will make the largest health care service in the world. The Government which is looking forward to the elections in 2019 is all set to woo voters with this scheme, a move that will very well help that bag the prize. However, according to Owen O’Donnell, tt will not be possible for healthcare providers to respond to such a huge expansion of coverage without substantial investment in medical facilities and manpower. With the Government of India scurrying to rope in insurers as well as hospitals in the scheme, it seems with the lack of facilities and cooperation to meet such high demands, the launch of the scheme is still on the horizon.
6 July 2018
According to a report by National Health Profile (NHP) 2018, the total expenditure on health was just 1.28% of the total GDP for the FY 2018 as compared to 1.12 in FY 2010. The share on total public expenditure on health by Centre and State was 31:69 in the FY 2016.
FY17 saw only 34% or 43 crore people having health insurance which clearly implies that a large number of people are still paying from their own pockets to take care of expenses related to healthcare. Among the people with health insurance, 79% of them purchased a health insurance policy from a private company. Overall, 80% of people with health insurance fall under government-sponsored policies.
India saw their per capita public expenditure on health increased from Rs 621 in FY 2010 to Rs.1,657 in FY 2018. The report stated that India’s per capita public spending on health is considerably low as compared to other countries who are either moving towards spending more on public healthcare or have a universal healthcare program. According to a health survey conducted by NSSO, the average medical expenses incurred during a person’s stay at a hospital is Rs.24,436 and Rs.14,935 for urban and rural areas respectively.
5 July 2018
Insurance Regulatory and Development Authority (IRDA) has received a proposal for the payment of health insurance premiums in installments in future.
A 35-year-old non-smoker will be required to pay Rs.25,000 - Rs.30,000 per annum for a health insurance policy worth Rs.25 lakh. If the move is implemented, then the person will only have to pay Rs.2,100 - Rs.2,500 per month for such a scheme.
The IRDA board which met on June 29 were supposed to discuss this proposal along with other issues such as the LIC’s proposed purchasing of a major stake in the IDBI Bank, and preference in treaties for foreign insurance company branches.
4 July 2018
Prasun Sikdar has been appointed as the new MD and CEO of the health insurance company Cigna TTK.
Sikdar will take over from Sandeep Patel who was previously the CEO and MD of the company. He will also be one of the directors on the Cigna TTK Health insurance board and will also be the Chief Strategy and JV Officer of the company.
Sikdar has more than 22 years of experience, as he was previously the Global Head and Group President at the Yes Bank where he managed mutual fund partnerships and alliances and also played a role in the growth of few key bancassurance. He was also a part of the ICICI Prudential Life Insurance where he worked as one of the founding members and senior general managers for the sales and distribution and department. Sikdar has also worked for Citicorp and GE Capital (SBI Cards).
Cigna TTK is a joint venture between the Indian company TTK Group and US-based company Cigna Corporation.
30 June 2018
Prime Minister Narendra Modi, on June 26, said that the National Health Protection Scheme (NHPS) will expand the number of healthcare facilities available in the country as well as increase job opportunities. There will be a greater demand for high-quality medicines, and certain medical consumables and equipment. Also, there will be a need for additional staff, call centres, IEC activities, research and evaluation, and so on which will certainly provide job opportunities to many. Since the primary objective of NHPS is to provide financial aid to the underprivileged masses of the country, the government will indirectly help the people save and invest by increasing the people’s disposable income.
The NHPS, also popularly known as Modi Care, is an ambitious health insurance scheme created by the central government with the intention to provide health insurance coverage to the poor masses of the country.
28 June 2018
NITI Aayog will step in to resolve an ongoing dispute between the government and private hospitals over rates related to different medical procedures under Ayushman Bharat National Health Protection Scheme.
The planning committee depending on the studies made by them will decide on the rates which should be revised next year.
The Indian Medical Association did not agree with the packaged rates as it would compromise on the quality of service and put the patients at risk. A draft tender document showed that the variety of procedures were priced lower by one-fifth to what the scheme had to offer.
27 June 2018
Narendra Modi has unveiled a free health insurance scheme for the underprivileged section of the society. The plan, which will offer coverage for Rs.5 lakh per family, was expected to cover about 5 crore people. But after a recent development wherein the health insurance schemes that are being implemented in the state already are going to be merged with the national insurance scheme, 15 crore people are expected to be beneficiaries of the scheme. The beneficiaries of the plan will be chosen based on the socio-economic census of 2011. Majority of the states have certain health schemes of about Rs.2 lakh in place and the national scheme will further increase the coverage amount and the number of beneficiaries of the policy. The new national scheme will offer health coverage to 40 per cent of the country’s population.
26 June 2018
According to Preeti Sudan, Secretary of the Ministry of Health and Family Welfare, increased spending on healthcare is one of the top priorities of the government. She noted that the government is committed to spending about 2.5% of the country’s GDP on healthcare. The newly proposed Ayushman Bharat-National Health Protection Mission will help the government achieve this objective.
This scheme, commonly known as ‘Modicare’, aims to cover 100 million families in India by providing coverage for up to Rs.5 lakh per family. This program has been approved by the Cabinet. Following this approval, the government has already allocated about Rs.10,000 crore for this scheme.
People who have enrolled in this scheme can get cashless treatment in various state and central government medical facilities. Private hospitals will also be empanelled in the network based on specific criteria.
23 June 2018
In what reflects the dismal state of healthcare services in India, according to a report by the World Health Organisation (WHO), India spends just over a 1% when it comes to healthcare services. In comparison, Bhutan stands at 2.4% and Sri Lanka at 1.6%. Despite the per capita has gone up from Rs.621 to Rs.1,112 from 2009 to 2015, India is still behind neighbours Sri Lanka and Bhutan. The numbers are based on the National Health Profile which takes into consideration the health status, the healthcare resources in the country, the socio-economic status and the demography - a report that is released every year by the WHO. According to the report, India has just one doctor for 11,082 people and only 34% of the country are covered by health insurance policies. To better these numbers, the Government of India is all set to roll out the National Health scheme or ModiCare on August 15, 2018. The scheme will cover almost 10 crore families with an annual sum assured of Rs.5 lakh. Despite the possibility of the healthcare scheme bettering the penetration of health insurance policies in the country, the out of pocket expenses of the health scheme seems to be put in the shade. A clause that most impoverished families will not be aware of.
23 June 2018
Ayushman Bharat – the ambitious National Health Protection Mission of the central government is likely to help create 1 lakh jobs over the next 4 years in the country. The long-term jobs are likely to give a boost to the economy.
It is expected that the expansion of private hospitals will be the biggest contributor towards these job openings.
Around 25,000 hospitals are likely to be empanelled under the scheme, which is likely to result in the opening of new hospitals. These new hospitals could directly contribute towards hiring.
The scheme could also result in the creation of around 80 lakh unskilled/semi-skilled jobs in fields such as construction. Around 2 lakh individuals could also be hired on a short-term basis.
Under the scheme, a cover of Rs.5 lakh will be provided to around 100 million families in the country.
22 June 2018
The National Health Profile 2018 stated that health insurance is still a growing segment in India, and it is yet to fully take off in the country. The report stated that the increase in cost of insurance has resulted in inequity in accessing health care service across the country. It also noted that per capita spending on health has increased significantly in the recent years.
Among those who have health insurance in India, 79% are covered by public insurance companies whereas the rest are covered by private insurers. When it comes to public expenditure on health, the contribution of centre-state ratio stood at 31:69 during the fiscal year 2015-16.
Though the contribution of the centre towards the public health expenditure has declined in the recent years, the national level programmes launched by the government helped a lot in tackling various communicable and non-communicable diseases over the last two decades.
21 June 2018
According to the most recent National Health Profile (NHP) data, India currently only spends a little over 1% of its total GDP on health. The country’s per capita public expenditure on health, however, did rise from Rs.621 in FY09-10 to a sum of Rs.1,112 in FY15-16. Compared to other countries, this increase is considered very modest.
In comparison, Switzerland and the UK spend $6944 and $3500 on health per capita, respectively. Similarly, the per capita expenditure on health in the US amounts to $4802.
India’s statistics are, however, expected to change after the introduction of the Ayushman Bharat scheme. The government-backed scheme will provide coverage to more than 10 crore families in India.
21 June 2018
It was recently announced that business will be divided in a 50:50 ratio between state-run insurance companies and private-sector insurers in states where state-run insurers match the bids of private insurance companies. The various state-run insurance companies are United India Insurance Company, National Insurance, Oriental Insurance, and the New India Assurance Company.
The insurance premium for the scheme has not been fixed yet. Individuals who are enrolled under the scheme will be able to avail cashless treatment up to a sum of Rs.5 lakh per family on an annual basis. For this scheme, it is likely that before unique IDs are issued, beneficiaries will be identified through their mobile numbers.
20 June 2018
Eight more Indian states have signed MoUs with the Health Ministry to implement the Central Government’s National Health Insurance Scheme in their respective states. This takes the total count of the number of states on-board to 20.
Mr. JP Nadda, the Union Minister of Health, exchanged MoUs with the health ministers of the states that will be implementing this scheme to mark their commitment towards the execution of the same. The National Health Insurance Scheme will provide health insurance coverage to 10 crore economically vulnerable families. The scheme will offer a sum insured of Rs.5 lakh per family annually.
16 June 2018
The government has fixed the rates on health insurance, ignoring the protests of the private hospitals. The health insurance reimbursements were fixed for 1,354 medical procedures under the government’s new scheme. They have confirmed that these fixed rates will not be revised any further.
The private sector hospitals protested against the new reimbursement rates offered under the government’s new scheme, saying that the rates fixed are too low. The government is determined to go ahead with the new rates without giving into the tactics of the hospitals to increase the health insurance rates under the Ayushman Bharat scheme.
14 June 2018
Apollo Munich launched a new flagship initiative called Roshni that aims to empower women of the socially and economically weak sections of the society. Apollo Munich has been a successful health insurer in India and took up this significant step towards the ‘Making India Health Confident’ programme. Towards implementation of the initiative, Apollo Munich and Apollo Mediskills Ltd. will provide free paramedic education to deprived women in semi-urban areas in India. The focus of the initiative is on women and the girl child and wishes to empower women by making them skilled and financially independent. This programme, in the process, will address the concern of shortage of paramedics in general, in the country.
The CEO of Apollo Munich Insurance, Mr. Antony Jacob, said that over a period of 10 years, the company has helped 30 million people and has steadily fulfilled the programme, ‘Making India Health Confident’. The company offers simple but innovative products that customers can benefit from. The new Roshni initiative will improve the position of women in the society with their association with the company.
14 June 2018
Technical glitches may delay the launch of Aysuhman Bharat, India’s most awaited health insurance plan. The government refused to give a launch date until and unless the IT platform is fully stable. This means, that the original date of launch- 15 August will be pushed to a later date with the scheme expected to make its debut on 2 October.
The IT platform will play an important role and help insurance companies in settling claims in a quick and smooth manner. The platform will connect insurance companies, third-party administrators, and health agencies with its customers and for this to happen it needs to be glitch free.
Eight states have already signed a MoU with the Central Government and 12 more states are expected to become a part of the scheme by June 14.
14 June 2018
With health insurance sceptical over the years to offer coverage for treatment abroad, it seems like this hurdle is going to be jumped. Over the last few months, insurers in the country are doing everything in their might to please their customers and to increase the penetration of health insurance in the country. Paving the way for the dawn of a new era in Indian health insurance, New India Assurance announced that they would be offering their customers with a health insurance which will enable them to receive treatment abroad. According to the insurance company that has made a noteworthy move, they said that a number of customers prefer to receive treatment abroad and making a consideration for them in particular, the insurance company rolled out a health insurance policy to receive treatment abroad over the last few days. However, keeping the cost of treatment abroad, customers will have to shell out a little more to purchase such policies which offer coverage for health treatments abroad. According to Business Standard, customers will have to pay significantly more for the premiums and the co-payment option will be limited to 20%.
14 June 2018
The public sector undertakings (PSU) overruled the Rajasthan government’s decision to remove 66 hospitals over fraudulent claims. The fraudulent claims were made in the Bhamashah Swasthya Bima Yojana (BSBY), a health insurance policy that offers financial support against various illnesses. It was launched to offer cashless medical insurance to the Below Poverty Line (BPL) families, free of cost.
The Rajasthan State Health Assurance Agency (RSHAA) and New India Assurance Company (NIAC) are in the process of trying to resolve the issue after the PSU overthrew the government’s decision. A few days earlier, the 66 hospitals were in fact removed by the Rajasthan government over the fraudulent claims that were made in association with the BSBY policy. These 66 hospitals were reported falsely charging the patients for medical procedures that eventually lead to a rise on the number of insurance claim made year after year, since the policy’s inception in December 2015.
13 June 2018
According to Union Health Minister JP Nadda, the government will sign memoranda of understanding with a maximum of states on June 14 to launch its ambitious health insurance initiative Ayushman Bharat National Health Protection Scheme. Some of the states expected to sign the agreement include Jharkhand, Gujarat, Madhya Pradesh, Chattisgarh, Bihar, Uttar Pradesh, etc.
There are about 5 states that are yet to confirm whether or not they would be implementing the Ayushman Bharat Scheme in their states. This includes states like Odisha and West Bengal. According to the deputy CEO of Ayush Bharat, the government expects about 20 states to sign up for the program by the end of this week and 25 by the end of this month.
Ayushman Bharat Scheme is an ambitious health insurance programs that aims to provide coverage for people belonging to low-income households. This program focuses on providing health insurance for about 50 crore individuals belonging to 10 crore families in different parts of the country. The proposed coverage under this scheme is Rs.5 lakh per family on a floater basis.
13 June 2018
According to a report by Bajaj Allianz General Insurance, health insurance claims witness a sharp rise during the monsoon season. The company reported that there is an 82% increase in claims attributable to monsoon related ailments over the past three years.
Based on the internal claims data, Bajaj Allianz reported higher claims during the monsoon season among children of age group 0 to 10 years and adults of age 21 to 40 years. The data revealed that viral fever is the biggest culprit of this season with about 119.5% growth in claims. Other illnesses like dengue fever and gastroenteritis showed 97% and 71.5% growth, respectively.
With the massive growth in seasonal illnesses, people must take precautions to ensure that they are well-protected against microbes. Some of the precautions like drinking boiled water, avoiding street foods, staying away from mosquitoes, etc. can go a long way in protecting one’s health.
9 June 2018
Government is going to introduce Ayushman Bharat in league with the existing state health plans. In Telangana, the Ayushman Bharat scheme will be launched in association with Aarogyasri, while in Tamil nadu, the scheme will be launched in association with the Comprehensive Health Insurance Scheme. The scheme to be launched in Maharashtra will be in association with the Mahatma Jyotiba Phule Jan Arogya Yojana. The first meeting of Ayushman Bharat-National Health Protection Mission Council (AB-NHPMC) to discuss policy directives and encourage coordination between the Central and State governments will take place on 14 June, 2018 in Delhi.
8 June 2018
In what would prove to be their highlight since the inception of the company, Aditya Birla Health Insurance have reported that they have had a massive year-on-year growth in their retail business sector. Commenting on the growth, the jubilant Managing Director and Chief Executive Officer, Aditya Birla Health Insurance, Mayank Bathwal, said that their retail business has grown by 253% as of April, 2018, as compared to the numbers in April 2017. Looking to expand their business significantly, Mayank Bathwal said that as compared to the FY 2016-2017, FY 2017-2018 has seen the company move in the right direction and the growth has been exponential by a massive 253%. The Managing Director and Chief Executive Officer of Aditya Birla Health Insurance added by saying that seventh bancassurance partnership with Karur Vysya Bank, which was announced by the health insurance company as well as the bank on Tuesday, June 5, 2018.
7 June 2018
A meeting was held recently in Telangana to inaugurate the launch of health insurance plan exclusively for the state lawyers. A. Indrakaran Reddy, the Law and Endowments Minister took part in the meeting and while addressing the audience asked all the advocates to take part in the state’s development process proactively. Health cards to all the lawyers insured under the health insurance plan were distributed at the meeting.
The minister also said that the government has come out with a number of schemes to safeguard the welfare of the advocates, including a Rs.100 crore corpus and health plan. Under the scheme, the advocates along with their spouses will be insured for a sum of Rs.2 lakh and a compensation of Rs.10 lakh each will be offered in case of any accidents resulting in death of the insured.
6 June 2018
In a close battle that was fought between heavyweights ICICI Lombard, HDFC ERGO, Warburg Pincus and Bain Capital along with 12 other bidders, in a few days, WestBridge will sign an agreement that will make the majority stakeholders of Star Health Insurance. According to a source, WestBridge along with billionaires Madison and Rakesh Jhunjhunwala led the race and have bought over almost 94% of Star Health Insurance. The company which is currently valued at Rs.6,500 crore was bought over by the aforementioned investors and current investors such as ICICI Venture, Tata Capital, Sequoia Capital will be given suitable exit options. The remaining 6% stake in the company will be held by Dubai-based ETA trading amongst ongoing dispute. Currently one of the leading insurers in the country, the company currently has a capital base of Rs.1,050 Crore, and has recorded a profit of Rs.210 crore and an underwriting profit of Rs.50 crore in the financial year of 2017-2018 - a 40% growth in gross written premiums. Tipped to be the biggest shareholder, ICICI Lombard eventually pulled out as they did not agree with the valuations as well as did not want to get into the legal disputes that has recently tainted the stakeholders.
5 June 2018
The state government of Uttar Pradesh has decided to add to the National Health Protection Scheme (NHPS) or Ayushman Bharat by designating certain individuals to help villagers understand and avail the national medical insurance scheme. The individuals will be known as ‘Ayushman Mitras’ or Ayushman friends. The responsibility of each ‘Ayushman Mitra’ will be to educate the people with regard to the scheme, help them apply for the scheme as well as guide them through the claim process. They will act as the point of contact for the villagers. This will make it easy for the villagers who may not have the best access to resources that will help them understand or follow procedures. The government has planned to appoint an official for each of the rural dispensaries. Uttar Pradesh estimates that around 1.18 crore families which will be equal to around 6 crore individuals will be covered under the national health insurance scheme launched by PM Narendra Modi.
1 June 2018
A tender will soon be floated by the Odisha Police so as to select the insurance company that will provide cover to 72,145 cops and the members of their family.
Currently, each police personnel can only reimburse up to Rs.10,000 of their medical bills and only 25% of the total police force purchased individual insurance schemes for themselves.
The proposed health insurance policy will cover hospital care, doctor’s services, pregnancy, childbirth, comprehensive drugs coverage and other diseases and health conditions. The premium amount is yet to be finalised.
30 May 2018
A report by SBI General Insurance stated that the number of claims made by women between age 35 to 45 for breast cancer has doubled in the last two fiscal years. The survey was conducted by the insurance company to spread awareness regarding the importance of having a health insurance to commemorate ‘International Day of Action for Women’s Health’ which is observed every year on May 28. The increase in the number of claims under this particular age group clearly indicates that women need to take care of their health from a very early age by taking certain precautions.
The report stated that nearly 85% of the claims made by women were from metropolitan cities which could be due to better set up of hospitals and more awareness amongst ladies who lived in metro cities.
30 May 2018
The Chief Minister of Himachal Pradesh, Jai Ram Thakur laid down the foundation of four outpatient departments of the Composite Regional Centres for Persons with Disabilities in the town of Sundargarh on Tuesday in a function.
It would take Rs.30 crore for the construction of the OPD and will have a hostel which will house 100 girls and boys with disabilities.
The function was attended by the Minister of Social Justice and Empowerment, Thawar Chand Gehlot and Health Minister, J.P. Nadda where the latter acknowledged the composite centre to be a milestone for the empowering of the physically disabled.Nadda also added that all the acid victims will also be given the status of physically disabled and the new government buildings will be disabled friendly.
30 May 2018
The Association of Healthcare Providers of India (AHPI) has said that the rates that have been proposed by the Central Government of India under the National Health Protection Scheme (NHPS) for various medical procedures are low and could compromise the safety of patients.
The organisation has said that the proposed rates are significant lower that the costs that are typically incurred for the procedures in tertiary-care hospitals. It is, thus, expected that the government will review the proposed rates through consultations.
The National Health Protection Scheme (NHPS) is a government-sponsored health insurance scheme that is expected to provide coverage to around 10 crore economically vulnerable households. The scheme will provide a cover of up to Rs.5 lakh per family annual for secondary- and tertiary-care hospitalisation.
29 May 2018
New India Assurance, a leading public-sector general insurance company, is looking to bring down its health loss ratio to 95% in the current fiscal. In FY18, the insurer’s health-loss ratio reduced to 103% from 114% in the previous financial year. The company is looking to break-even by FY20 by bringing its health-loss ratio down to 85%.
With regard to claim settlement, the insurer has recruited several doctors to make the process more professional. Further, the insurer is also using its own TPA called Health Insurance TPA India for claims settlement.
For the whole of FY18, New India Assurance witnessed a 118% growth in its net profit to touch Rs.2,201 crore, as compared to Rs.1,008 crore in the previous fiscal. The company’s gross written premium also increased by 15.3% to touch Rs.26,554 crore in FY18, against Rs.23,020 crore in FY17.
28 May 2018
Non-profit organisation India Network Foundation is celebrating its 30-year anniversary by providing one month free health insurance for visitors from India travelling to the United States. This insurance coverage can be availed by members and visitors irrespective of their age. Some of the member-supported projects of India Network Foundation include map distribution for elementary schools in India, Orissa Cyclone Relief, water distribution in villages, Gujarat Earthquake Relief, etc.India Network Foundation is an organisation established in 1988 to serve the Indian community in different parts of the country. It started out as a resource for India-related news in different parts of the world. As a part of its efforts to help the communication, the organisation also sponsors health insurance to the people travelling to the United States.
26 May 2018
Top officials from several general insurance companies have now said that health insurance policyholders who might have to undergo a heart transplant operation may even get insurance coverage for transportation of the organ, in addition to other procedure-related costs, if the concerned individual has sufficient cover.
For heart transplant operations, transportation of the organ in a timely manner is crucial. As per international protocol, organs need to be transplanted within four hours. Thus, transportation of the organ will usually have to be done by air. Given how expensive this can be, insurance companies have said health insurance plans can cover transportation costs if a policyholder has sufficient coverage, unless otherwise mentioned.
26 May 2018
Telangana Chief Minister K Chandrasekhar Rao will launch new policies on June 2 including welfare measures for advocates. June 2 which marks the day on which the state of Telangana was formed will also see Rao launching Dharani an online registration site.
The welfare scheme will provide the advocates and their spouse with an insurance cover worth Rs.2 lakh. The government has also signed an agreement with various insurance companies to provide Rs.10 lakh as financial cover to advocates in case of an accident. More than 18,000 advocates have already enrolled themselves under this scheme.
A cheque of Rs.8.5 crore was handed to the United India Insurance Company and Rs.33 lakh to Oriental Insurance Company by Endowment and Law Minister, A Indra Karan Reddy for providing health insurance coverage to the advocates.
24 May 2018
Telangana Chief Minister K Chandrasekhar Rao will launch new policies on June 2 including welfare measures for advocates. June 2 which marks the day on which the state of Telangana was formed will also see Rao launching Dharani an online registration site.
The welfare scheme will provide the advocates and their spouse with an insurance cover worth Rs.2 lakh. The government has also signed an agreement with various insurance companies to provide Rs.10 lakh as financial cover to advocates in case of an accident. More than 18,000 advocates have already enrolled themselves under this scheme.
A cheque of Rs.8.5 crore was handed to the United India Insurance Company and Rs.33 lakh to Oriental Insurance Company by Endowment and Law Minister, A Indra Karan Reddy for providing health insurance coverage to the advocates.
23 May 2018
JLT Independent Insurance Brokers has recently crossed their sales mark by achieving a turnover of more than Rs.1,000 crore in India. The firm is a joint enterprise between Sunidhi Group of India and Jardine Lloyd Thompson (JLT) Group, a major global insurance broking firm. JLT Independent Insurance Brokers is giving a tough competition to all the other firms that belong to the insurance broking sector, especially since the firm reached their sales mark within 3 years of its inception in India.
The CEO of JLT Independent Insurance Brokers, Sanjay Radhakrishnan, has confirmed that the firm is looking for acquisitions in India. JLT Independent Insurance Brokers, in 2016, acquired Vantage Insurance Brokers and is now open to new acquisitions in 2018. JLT Independent Insurance Brokers is looking at firms that are present in the same areas of business as the firm is in.
22 May 2018
Creative digital agency Digitally Inspired Media Pvt. Ltd. has bagged the deal to perform all the digital duties for standalone health insurance company Star Health and Allied Insurance. The account for Start Health will be managed from the chennai office of Digitally Inspired Media.
In addition to handling Star Health’s digital assets, Digitally Inspired Media will also manage the company’s engagement planning activities and communication strategy. According to the digital agency, its understanding of Star Health’s business was crucial in developing a strategy that aligned with the company’s vision.
Digitally Inspired Media is a digital agency with offices in three different locations - Chennai, Bengaluru, and Mumbai. Star Health adds to the company’s long list of reputed clients that include ZEEL, Saint Gobain India, Kaleesuwari Refinery, etc.
22 May 2018
India’s Union Health Minister JP Nadda stated that the country is committed to achieving universal health coverage as per the framework set forth in the National Health Policy of 2017. The minister said this while leading the Indian delegation in the World Health Assembly, which happened Geneva.
While addressing the plenary meeting in the 71st World Health Assembly, India has fast-tracked its activities to achieve universal health coverage for all its citizens. He also noted that the country is focused on improving health system, providing access to free medicines to the population, and minimizing catastrophic health expenditure.
During the meeting, he also spoke about the government’s recently launched Ayushman Bharat scheme, which aims to provide free health coverage for the country’s low-income population. The scheme, which was announced by the government during its latest budget session, aims to cover 500 million individuals belonging to 100 million families.
This scheme will provide insurance cover worth Rs.5 lakh per individual. Nadda also stated that this scheme will be the largest government-funded health insurance scheme in the world. He also addressed the Commonwealth Health Ministers Meeting on the sidelines and spoke about tackling non-communicable diseases.
22 May 2018
Indians who return to their homeland from UAE can now enjoy continued benefits from their health and accident insurance schemes. This is a new scheme named My India care that ensures that Indians are covered under the policies until the end of their lives when they return to India. This scheme is an initiative by National Takaful Company and Gargash Insurance Services.
Earlier, Indians would find it difficult to obtain a health insurance scheme after returning from the UAE, especially if they were in their old age. But now, expats can enjoy benefits of existing medical and personal accident plans, thanks to My India Care. The policy offers advanced medical facilities and can be bought online too.
20 May 2018
MTaI (Medical Technology Association of India) suggests that the quality of service being delivered be borne in mind while keeping the costs low under the NHPS (National Health Protection Scheme) – a national healthcare scheme proposed by PM Narendra Modi. MTaI is an interest group of top medical technology companies. The Director of MTaI, Kaustav Banerjee is of the opinion that if the cost of hardware, prosthesis, implants, and risk consumables are subsumed without quality standardisation, the resulting therapies might be cheap but will be substandard.
The solution to this significant probable problem is to make the NHPS a value-based scheme that keeps an eye on the outcome of every rupee spent under the scheme. If the government does not emphasise on quality, the manufacturers will only focus on reducing costs of devices and not on the outcome. This will affect the payer of the device as well as the patient.
19 May 2018
A memorandum of understanding (MoU) has been signed between National Health Agency (NHA) and the Uttarakhand Government to provide health insurance cover to more than 20 lakh families under the Ayushman Bharat scheme. The document was signed by Indu Bhushan, the CEO of Ayushman Bharat Scheme and Nitesh Jha, Uttarakhand secretary health department in the presence of Uttarakhand CM Trivendra Singh Rawat and union health minister JP Nadda.
Each family enrolled under this scheme will be provided with the facility of free treatment of upto Rs.5 lakh. There is no limit to the number of members in a family that can avail this benefit. The scheme which was earlier designed only for the 5.4 lakh families under below poverty line (BPL) will now be extended to be used by over 20 lakh families in Uttarakhand. The state thus will become the first state in India to provide an insurance of such magnitude to the people.
16 May 2018
A Memorandum of Understanding (MoU) was entered into by the State government of Uttarakhand with the National Health Protection Mission (NHPM) to provide free and comprehensive health insurance coverage for the people of the state. The MoU was signed between Preeti Sudan, the Union Health Secretary and Nitesh Jha, the State Health Secretary.
The Chief Minister, Trivendra Singh Rawat, stated that the health cover will be a great gift to the citizens of the state. He said that 5.38 lakh families will be covered under the scheme. An important feature of the health plan is that patients can avail the cashless facility in any of the empanelled hospitals of the country. Also, the life insured individuals can avail free treatments in super speciality hospitals within and outside the state. Rawat said that they have been inspired by the Ayushman Bharat Scheme proposed by the centre and hope to cover all the vulnerable families of the state.
16 May 2018
The Health Minister of Punjab, Brahm Mohindra, refused to sign the MoU (Memorandum of Understanding) with the Centre for the Ayushman Bharat scheme stating that the state already has similar health care schemes. Further, he did not find the 60:40 funding plan acceptable. J.P. Nadda, the Union Health Minister, invited Mohindra to join him in Delhi to discuss the issue.
Mohindra stated that existing schemes already benefit the people of Punjab and that the Ayushman Bharat scheme has certain issues. Nadda said that the Centre wishes to implement the scheme throughout the country and will hence discuss the objections the states may have and address them for better implementation. The states Uttarakhand, Union Territory of Chandigarh, Haryana, Jammu and Kashmir, and Himachal Pradesh signed MoUs with the Centre for the Ayushman Bharat scheme -which is one of the largest government-funded healthcare schemes that will provide coverage up to Rs.5 lakh per family.
16 May 2018
In January 2017, the state government of Jammu and Kashmir announced that a Cashless Health Insurance Scheme will be introduced to provide health coverage worth Rs.5 lakh per family for families under the Below Poverty Line. According to a report, this number adds up to 10.35% of the state’s population. Minister Sajjad Gani Lone of the Social Welfare Department had announced the scheme and had mentioned that the state will bear all costs to implement the scheme.Rifat Arif, the Special Secretary of the Social Welfare Department said that the implementation of the scheme has been delayed since they are looking into various aspects of the scheme such as empanelment of public and private hospitals, looking for a society to run the scheme and much more. He added that the scheme is under active consideration and that the scheme will be implemented once all the formalities are done.
15 May 2018
Construction workers throughout the country will now have access to various social benefits that include life insurance, health insurance, disability insurance, pension, housing, etc. This plan is loosely based on the draft domestic workers policy, and it will be part of a welfare scheme prepared by the central government.
According to an official from the labour ministry, this government initiative focuses on providing equal benefits to all sections of workers. A construction worker can access all the above mentioned benefits by registering with the board.
The Supreme Court has earlier directed the Central Government to come up with policies with the welfare of construction workers. It also urged the Central Government to use the cess to provide social benefits for these workers.
According to an estimate by the International Labour Organisation, construction workers formed about 14.4% of the total working population in India in the year 2000. This has increased to 30.1% in the recent days.
15 May 2018
The NHPS (National Health Protection Scheme) is a health insurance scheme introduced by the Indian government to offer health insurance coverage for the vulnerable sections of the society. Public and private insurers were to be included in the scheme. Niti Aayog had initially stated that they would provide Rs.1,000 per policy to the participating insurance companies. This created a budget of Rs.12,000 crore p.a. for the scheme. However, the Niti Aayog later proposed that Rs.2,500 be paid per policy to the insurers. This would bring up the budget to Rs.2,500 crore which is twice the initial budget. The Prime Minister’s Economic Advisory Council (PMEAC), hence, asked the Niti Aayog to revise the budget for the scheme.
The PMEAC also noticed that no solid structure was created by the Niti Aayog for the participation of private insurers. It has therefore asked Aayog to define a framework that can be followed.
12 May 2018
The stake sale of Star Health and Allied Insurance is expected to be delayed as an investor of UAE- based ETA Trading – Ahmed Abdulla Ahmed Al Ghurair has moved the High Court of Madras against the health insurance company. The reason is that shareholders wish to have beneficial rights in the company. Since the issue will take some time to be resolved, the stake sale is most likely to be delayed.
The investor who has moved the High Court has a 6.17% stake in the company. Tata Capital, ICICI Venture, Sequoia, Apis and Oman Insurance Company together have a 70% share in the company. The rest of the share is held by ETA Trading. The highest bidder of Star Health’s stake sale is ICICI Lombard with a bid as high as Rs.6,500 crore. Westbridge Capital and PremjiInvest are also eyeing the stakes.
10 May 2018
The BMC (Brihanmumbai Municipal Corporation) of Mumbai discontinued the group health insurance scheme that covered as many as 1 lakh employees of BMC. During the civic standing committee’s meeting held on Wednesday, the opposition party walked out of the meeting as an opposition to the BMC’s move.
The employees were covered under the group policy until July 2017 but the civic body discontinued the policy as the insurance company increased the cost of the scheme from around Rs.117 crore to Rs.142 crore. The leader of the opposition party, Ravi Raja stated that the scrapping of the plan had caused inconvenience to many. Officials from the Samajwadi Party, the NCP, and the Congress were found holding banners to proclaim their disapproval. Rais Shaikh, the leader of the Samajwadi party said that employees will face inconvenience until the lengthy process of finding a new health insurance policy takes place.
10 May 2018
Royal Sundaram General Insurance recently launched a unique health insurance plan by the name ‘Family Plus – The 5G Health Insurance Plan’. It is a family floater that permits as many as 19 members to be covered under a single policy. There are no restrictions on the number of adults and children. Each of the members of the policy will be covered by an individual sum assured. Further, members can also enjoy the benefits of the floater sum assured. This provides the members with 2 layers of protection.The Chief Product Officer of Product Factory, Nikhil Apte, stressed on the importance of health insurance in today’s times due to the rise in critical illnesses and the possibility of medical inflation in the near future. He also listed out the other benefits of the plan such as the No Claim Bonus and the Reload feature.
10 May 2018
The NITI Aayog has requested the World Bank to assist them in creating a fraud-free health insurance scheme. They have asked for information that will help them detect and prevent fraudulent acts in the National Health Protection Scheme (NHPS) which is set to be rolled out soon.
The assistance of the World Bank was sought since it is proficient in international experience. The World Bank is expected to provide a report of how various countries with national health insurance schemes have created a mechanism to prevent fraudulent acts and corruption. The Chief Officer of the NHPS, Indu Bhushan, said that they will study the report provided by the World Bank and implement recommendations that are relevant in the Indian context. Further, the health ministry has already proposed that insurers have to return excess premium amounts in case the claim settlement ratio is 85%. This prevents insurance agencies from making fraudulent gains.8 May 2018
A consultation paper about the National Health Protection Scheme (NHPS) which was circulated among stakeholders for discussion revealed that Aadhaar will be utilised to identify beneficiaries of the scheme. This decision must have been taken due to the fact that Aadhaar has played an important role in preventing leakages in many government welfare schemes. The consultation paper, however, has not stated that Aadhaar is mandatory. It has been said that ration card details will be requested from the members of the scheme and also that any government document or ID will be accepted in place of Aadhaar.
The National Health Protection Scheme, also known as Modicare, is a proposed health insurance scheme that is said to provide coverage equal to Rs.5 lakh per family to the vulnerable sections of the society. The scheme is expected to be rolled out soon and final decisions are being taken for the same.
8 May 2018
The state government of Goa is likely to extend the health insurance scheme – Deen Dayal Swasthya Seva Yojna with United India Insurance Company Ltd. A tender was floated in the month of March and two insurance companies made bids. The quote of the lower bidder was a premium of Rs.8,100 per family as against the existing rate at Rs.2,800 per family. Since the government cannot afford a Rs.300 crore scheme, it has decided to extend the present scheme until the month of August. The liability of the government in terms of this scheme is Rs.80 crore.
Many changes are said to be implemented in the revised scheme but the government held that it cannot afford Rs.8,100 per family. Vishwajit Rane, the Health Minister, admitted that the scheme has certain loopholes. A few officials believe that this scheme will not be necessary since the National Health Protection Scheme will be launched shortly.
7 May 2018
A joint venture between Murugappa Group and Mitsui Sumitomo Insurance, Cholamandalam MS General Insurance made as much as Rs.4,103 crore as the gross written premium for the quarter that ended on March 31st, 2018. The MD of the company, S.S.Gopalarathnam said that the target for the FY 2019 is Rs.5,500 crore and they aim to be one of the top 5 private insurance companies in the country.
The company has seen a steady growth every year and the growth exceeded the 25% mark for the third consecutive year. The MD said that they have achieved optimum growth and receive a 20.5% equity return. Retail is the focus of the company in the growth perspective and motor insurance, health insurance, and crop insurance contribute to 80% of the premiums from both metros and non-metros.
4 May 2018
The Ayushman Bharat scheme launched by the central government will benefit more than 45% of the total Indian population, Union Health Minister, J.P. Nadda said.
Speaking at a function commemorating Ayushman Bharat Diwas in Bilaspur, Himachal Pradesh, Nadda said that the scheme’s main focus was the progress and benefit of the common man and schemes similar to Ayushman Bharat have been launched in various areas.
Nadda also said that the scheme will aim to benefit more than 10 crore families who are vulnerable and poor. Ayushman Bharat scheme will provide Rs.5 lakh as health insurance cover to each family.
3 May 2018
A District Consumer Disputes Redressal Forum in Chandigarh directed Oriental Insurance Company Limited to pay a compensation of Rs.88,800 with a 9% p.a. interest. This came in response to a complaint made by Devki Nandan Vaid of Panchkula for rejection of his claim on grounds that no permission was taken from the company before the surgery was performed and that a reasonable amount equal to Rs.26,267 was provided to the policyholder.
Vaid, a senior citizen, had a health insurance policy that covered himself and his wife. The sum assured was Rs.5 lakh and the cataract surgery performed on his wife amounted to Rs.1.15 lakh for which cashless facility was not approved by the health insurance company. The company reimbursed Rs.26,267 but Vaid registered a complaint with the forum. The forum asked the health insurance company to provide a compensation and held that the claim made was genuine.
27 April 2018
While health insurance policies are mostly bought offline, a recent study proved that young individuals between ages 25 years and 44 years tend to purchase policies online. The study included 601 respondents who purchased health insurance policies in the past five years. While 30% of the age group said that they purchased the policy online, 33% of them reported to have bought the policy offline.
Out of the 601 individuals of the 25-34 years age group, 64% of them said that they filled the forms with the help of brokers or agents while the rest of them said they filled it out themselves. Shivakumar Shankar, MD of LexisNexis Risk Solutions India said that online purchase of policies is a good sign but customers tend to leave out relevant data or misreport certain facts. The reason, he says, could be the belief that providing certain details could lead to claims being rejected.
25 April 2018
The labour ministry had planned a social security scheme for 50 crore workers including those in the agricultural sector. The scheme is expected to require about Rs.2 lakh crore to cover 40% of the workforce. The rest are expected to pay for the scheme themselves either completely or partially. The labour ministry suggested that the government provide coverage for the needy first.
The government has planned to roll out the scheme in 3 phases over a 10-year term and then make it universal. The first phase will provide minimum coverage to the workers, the second will see to it that they are given unemployment benefits and the third phase will provide other welfare benefits. The 50 crore beneficiaries of the scheme will be divided into four tiers based on their contributory power and self-sufficiency. The contributions for the coverage will be decided accordingly.
24 April 2018
GoActive, a new and innovative product created by Max Bupa was named the Product of the Year. Max Bupa is a leading health insurer in India that has been consistently providing innovative products to their customers. GoActive is a specially designed product that caters to the daily health requirements of insured individuals. The objective of the insurance company is to bring about a significant change in the health insurance industry.
Product of the Year is a well-known consumer-voted award that is given to the most innovative products. The certificate is recognised internationally and is said to be the largest consumer-voted award in the world. Ashish Mehrotra, the MD and CEO of Max Bupa said that their goal is to increase health insurance penetration in India and to provide insurance policies that help individuals manage daily treatments as well.
24 April 2018
The labour department had taken an initiative to issue and renew health insurance cards to persons in the Ernakulam district of Kerala. According to the District Information Office, the highest number of health cards have been distributed in the state. As many as 1,95,868 cards have been distributed to families that possessed cards, 36,540 cards have been provided to families that applied for renewal and 59,179 cards have been provided to families that were unable to renew their cards in the year 2016. Further, 1,81,288 families that possessed cards were given smart cards.
Under the Rashtriya Swasthya Bima Yojana, five family members can receive medical treatment worth Rs.30,000. Also, treatment for diseases like cancer and liver ailments up to Rs.70,000 can be availed under the scheme. The card can also be utilised to provide treatment worth an additional Rs.30,000 for two elderly persons per card.
23 April 2018
Health insurance claims made under Rajasthan’s government-funded health care scheme – Bhamashah Swashthya Bima Yojana shot up from Rs.7.5 crore in the first week, after the scheme was launched, to Rs.20.3 crore in the seventeenth week. The current trend indicates that the claims ratio for the entire year could be as high as 120% despite an increase in the premium charged
The reason for the dramatic rise in claims, as discovered by New India, is the rise in fraudulent claims by hospitals. Hospitals have been found to admit patients without biometric authentication though it is a requirement under the scheme. The investigators at New India found two fraud types. One, where the hospital conducts no treatment or a cheap treatment but raises a claim for an expensive treatment. Two, the billing reports show a higher number of patients than the hospital can hold. Insurance providers hence complain about how fraudulent activities have become rampant due to ease on Aadhaar checks.
21 April 2018
The government is said to launch a pilot project in Haryana to test the feasibility of laying out a health cover under ESIC (Employees’ State Insurance Corporation) for building and other construction workers. Santosh Gangwar, the Labour Minister, stated at a conference that the pilot project will help the government understand the problems in implementing the scheme. He also suggested that the states should pay the ESI contribution that the employer pays and also file the ESI returns. He said that the building and other construction workers cess can be utilised to provide ESI contributions to employers and employees.
Gangwar stated that there are 5 crore construction workers in total and that 20 crore people will benefit from this scheme as even the family members of the workers will be covered under the ESI scheme.
20 April 2018
A Niti Aayog member, in Chandigarh, said that healthcare services under the National Health Protection Scheme (NHPS) are going to be provided through wellness centres. PM Narendra Modi launched the NHPS with the opening of a health centre in Bijapur, Chhattisgarh.
At an interactive session in Chandigarh, Vinod Paul, a Niti Aayog member, stated that secondary and tertiary health care services will be provided under NHPS through a network of public and private hospitals. Paul explained the enrolment of nominees, empanelment criteria of health care providers, and the importance of the role of tier II and tier III cities in the implementation of Ayushman Bharat or NHPS. He also emphasised on the need for better infrastructure in such cities because the target citizens are in close proximity to such cities.
The two major objectives of the NHPS is to create a network of wellness centres that provide excellent primary health care and provide adequate cover to the underprivileged masses of the country.
18 April 2018
Assam will roll out Atal Amrit Abhiyan (AAA), the state’s own comprehensive health insurance scheme on April 18.
Named after the former PM of India, Shri. Atal Bihari Vajpayee, the scheme will be inaugurated by the Vice President of India, Mr. M Venkaiah Naidu.
The insurance scheme is expected to provide coverage to more than 92% of the state’s total population and will provide cover against 438 procedures under six disease groups. Each beneficiary will also be eligible to get free treatment of upto Rs.2 lakh at select hospitals in both Assam and in cities like Bengaluru and Kolkata.
The scheme will cover families who belong to the below poverty line (BPL) and also families with annual income of upto Rs.5 Lakh.
AAA is the initiative of Himanta Biswa Sarma, the Health Minister of Assam who said that he drew inspiration to start a state owned health insurance scheme from the current Prime Minister of India, Mr. Narendra Modi.
18 April 2018
ICICI Lombard General Insurance Co, according to sources, is in talks to acquire Star Health and Allied Insurance Co. The second highest bidder for the esteemed insurer is a team of WestBridge Capital and Rakesh Jhunjhunwala, top stock market investor. The final transaction will bring the 18-month-long bidding process to an end. Many private equity funds like Warburg and Bain Capital as well as insurers like Bajaj Allianz and HDFC Ergo were a few of the companies that were interested in the bidding process. The third bidder that reached the final negotiation rounds were Prudential Plc with Premjiinvest.
Star Health, which was founded by V. Jagannathan in the year 1996, is the largest standalone health insurance company in India. The company is owned by a group of venture capitalists – ETA Trading, Oman Insurance Company, and Snowdrop Capital Pte Ltd.
17 April 2018
Apollo Munich Health Insurance, one of the leading private health insurers in India, has been named one of India’s 15 Best Workplaces in BFSI. This is an outcome of an annual study that is recognised as authentic worldwide and is conducted by Great Place to Work Institute of India. Apollo Munich has been awarded this prestigious position for the seventh consecutive year.
The trust factor between employers and employees along with employee-centric activities conducted by the management play an important role in bringing this award to the company. The driven culture created within the company increases productivity and inspires employees to find meaning in their everyday tasks. Five major parameters are tested for this award – credibility, fairness, team spirit, respect, and pride. Apollo Munich has excelled in all five parameters and hence won a place in the esteemed list.
16 April 2018
Vice President M. Venkaiah Naidu addressed a gathering at the 20th convocation of Rajiv Gandhi University of Health Sciences (RGUHS) and spoke about the shortage of doctors and health facilities in India. He stated that in a country of 130-crore people, only one doctor is available for every 1,000 citizens. He called for a public-private partnership in order to create affordable healthcare facilities in the country.
Naidu also pointed out that there is a divide in the facilities provided to the urban and rural areas. While cities are blessed with state-of-the-art facilities, rural areas hardly have basic facilities. He believes that the public and private sectors should come together to bridge and execute a plan that aims to provide excellent treatments at affordable costs. The Ayushman Bharat National Health Protection Mission (NHPM) that promises to provide health insurance to the needy sections of the society will soon be launched.
14 April 2018
The health secretary, through a letter, urged all state governments to adopt the Clinical Establishment Act. The aim of the act is to reorganise the healthcare service industry in India. The Center is of the opinion that the application of the act plays an important role in the implementation of the ambitious Ayushman Bharat-National Health Protection Mission (AB-NHPM).
The idea is for the states to conduct the necessary checks so that the beneficiaries of the plan reap maximum benefits. The act will be applicable to private as well as public sector industries. The letter sent out by the health ministry pointed out that the states will make a 40% contribution to the NHPM and hence a mechanism to monitor the industry needs to be put in place. The NHPM, popularly known as Modi Care, is said to be the largest health care programme in the world to be funded by the government.
13 April 2018
The leading rural healthcare provider in India is Gramin Health Care (GHC). GHC had made a turnover of Rs.1 crore in FY 2016-17 which increased to Rs.5 crore in FY 2017-18. It plans to increase the funds provided by investors in the coming two months. Ajoy Khanderia who is the founder and entrepreneur-evangelist of GHC said that they are in talks with prospective investors to receive funding.
Khanderia stated that the vision of GHC is for every farmer’s family to have a family doctor and a health insurance cover. The organisation envisions to become the top healthcare service provider in rural India. It has several full-time doctors and nurses as employees and has access to many doctors from clinics and hospitals.
13 April 2018
HDFC is in talks to buy Apollo Munich Health Insurance Co. for Rs.1,000 crore. The deal did not face many challenges as HDFC has a joint venture with Ergo, and Ergo International AG happens to be a part of the Munich Re group, a popular reinsurer in Europe. Apollo Munich is a partnership between Apollo Hospitals, based in Chennai, and Munich Re.
Apollo Hospitals is only second to Star Health in terms of the largest standalone health insurance companies in India. HDFC is said to have considered purchasing Star Health too. The Apollo Munich deal, however, is expected to be finalised soon. Apollo holds a 51% stake in Apollo Munich and Munich Re holds a 49% stake.
10 April 2018
PM Narendra Modi plans to launch the National Health Protection Scheme (NHPS) as well as the Van Dhan Yojana on the 14th of April, 2018 on the occasion of Ambedkar Jayanti. The NHPS is a health insurance scheme that is expected to offer coverage to the underprivileged section of the society. The Van Dhan Yojana, on the other hand, is a scheme that aims to empower tribals by training them to process minor forest produce.
The BJP Government has chosen this campaign to be conducted on the 14th of April which is the birth anniversary of Dr. B R Ambedkar. The place chosen is Bijapur district, Chhatisgarh which is filled with tribals who comprise nearly half the population of the state.
5 April 2018
The new measures taken by Finance Minister Arun Jaitley for FY 2018 proves to be highly beneficial to senior citizens. The deduction limit for health insurance premium or medical expenditure was Rs.30,000 under section 80D earlier but it has now been increased to Rs.50,000. Further, the deductions for certain illnesses under section 80DDB have been hiked from Rs.60,000 to Rs.1 lakh.
Section 80D and section 80DDB form a part of the Income Tax Act, 1961. The hikes in deductions limits reduce the financial burden borne by senior citizens.
4 April 2018
The Insurance Regulatory and Development Authority of India (IRDAI) defines a newborn as a baby aged up to 90 days and born within the policy period. The clarification of the definition by the IRDAI brings a sigh of relief to parents whose children are being treated in neonatal ICUs. The daily expenses incurred for such treatments range from Rs.17,000 to Rs.25,000.
The newborn definition has been communicated to the Newborn Medical Insurance Committee that is a part of the National Neonatalogy Forum. After clarification of the definition, parents can expect insurers to aid them financially with respect to the treatment of their newborn babies.
29 March 2018
American investment bank Goldman Sachs is planning to buy a stake in Indian insurer Royal Sundaram General Insurance Co. Ltd.
One of the person who cited anonymity regarding the matter said that Royal Sundaram wanted a partner to help them grow their business and Goldman Sachs is one of the interested parties to help them out.
29 March 2018
Punjab Chief Minister, Captain Amarinder Singh wants the proposed Punjab Social Security Fund worth Rs.2,000 crore to be used for providing pensions, health insurance and scholarship.
The fund set up under the new Social Security legislation should provide pension to 17.35 lakh people, health insurance to more than 45 lakh people and scholarship to over 3 lakh people including marriage grants under Aashirwad Scheme for two lakh girls. Captain Amarinder Singh made this proposal in the Vidhan Sabha pointing out that Congress has always aimed to increase pension for old and physically disabled people.
29 March 2018
Vishwajit Rane, the Health Minister of Goa will meet Devendra Fadnavis, CM of Maharashtra to resolve issues over charging of treatment fees to non-Goan patients in Goa Medical College and Hospital (GMC). The Health Minister will make proposals requesting the Maharashtra government to include Asilo Hospital and GMC in Maharashtra’s health insurance scheme or aid GMC to create an annual corpus fund that will allow them to treat patients without levying any charges.
Rane stated that the issue has created political agitations and wishes to resolve the problem as soon as possible by signing a Memorandum of Understanding with the CM of Maharashtra. Further, he plans to increase the treatment charges for foreign patients.
28 March 2018
The Union Cabinet chaired by the Prime Minister approved the launch of Ayushman Bharat- National Health Protection Mission (AB-NHPM) on Wednesday. The scheme promises to provide health coverage to almost 10 crore poor families in India.
An official statement said that the scheme, more famously known as Modicare will be available without any cap on the family size and age. The expenses for both pre-hospitalisation and post-hospitalisation will be covered under this scheme.
Modicare, termed as the world’s largest program to be funded by a government for public health will provide Rs.5 lakh as medical coverage per year to the families who are poor and cannot afford insurance for themselves. Other schemes like Rashtriya Swasthya Bima Yojana (RSBY) and Senior Citizen Health Insurance Scheme (SCHIS) will come under the umbrella of AB-NHPM.
23 March 2018
The Aam Aadmi Party (AAP) has recently promised health insurance coverage for all individuals residing in the state. In the state budget, the Delhi government has allocated a sum of Rs.6,729 crore for the state’s health sector. From this sum, it is reported that Rs.100 crore has been allocated for the health insurance scheme.
In comparison, the government allocated Rs.5,736 crore to the healthcare sector in 2017-18. The state government of Delhi has already set-up 160 Mohalla clinics in the state. Further, the government has identified about 530 land sites to set up new mohalla clinics, and have also identified 94 dispensaries that will be converted into polyclinics.
The health insurance scheme will be offered to all individuals residing in the state and seeking treatment at empanelled private and government hospitals, within Delhi. Trauma services with a reduced response time will also be provided to individuals residing in congested areas of the city.
23 March 2018
The Insurance Regulatory and Development Authority of India (IRDAI) recently announced that health insurance companies cannot reject claims on grounds that the treatment was conducted for a genetic disorder. Further, genetic disorders cannot be included as an exclusion in existing or new health insurance policies.
This came in response to the Delhi High Court’s statement about the ambiguity in the use of the term ‘genetic disorders’ in health insurance policies. The court had asked the IRDAI to revisit exclusionary clauses of health insurance policies.
21 March 2018
In a survey conducted on 1,000 women, it was found that only 6% of them are covered by a critical illness cover. And only 22% of them possess a health insurance cover. Women in metropolitan cities were found to be more cautious about health than the women in non-metropolitan cities. This is the state of affairs even though 88% of the respondents are of the opinion that lack of exercise is the cause for critical illnesses.
The study also revealed that only 79% of the respondents believe in the need for health check-ups but do so only once in 2 years.
21 March 2018
New India Assurance Company launched a mediclaim plan that offers lifetime health cover for global hospitalisation expenses. The cover includes expenses incurred for organ transplant, neurosurgery, cancer, heart surgery, and bone marrow transplant in hospitals abroad.
Kings College Hospital, John Hopkins Medical Center, and Cedar – Senai Medical Center are a few of New India Assurance’s foreign network hospitals. The plan provides coverage for treatments in Asian countries as well as treatments in a few other parts of the world. While the lifetime cover in Asian countries is offered for Rs.10 lakh, the lifetime cover worldwide is offered for Rs.20 lakh. Among the many services covered under the policy, a few of them are treatment expenses incurred in foreign countries, travel expenditure, accommodation charges, expenses incurred on repatriation of the mortal remains, etc.
21 March 2018
The Kerala government plans to provide health coverage to government employees and pensioners. The health cover, offered for a 3-year policy term, is said to be worth up to Rs.6 lakh. The health insurance will also cover the families of the employees and pensioners. The premium per month is expected to be Rs.300.
If the plan chalked out by the finance department of the Kerala government receives a go-ahead, employees will receive health coverage worth Rs.12 lakh for treatment of acute ailments. If the treatment costs exceed, the government is also willing to provide an additional Rs.3 lakh. As per the plan, 11 lakh employees are expected to be covered under the plan.
20 March 2018
According to the government’s projections, the implementation of NHPS (National Health Protection Scheme) will require close to Rs.10,000 crore to Rs.12,000 crore. However, only Rs.2,000 crore has been allocated for NHPS in the 2018 budget. When questioned about the same, Health Minister Nadda made it known that the Rs.2,000 crore is only the initial allocation of funds. The complete allocation was not made in the 2018 budget because the NHPS was planned to be launched later in the year plus many states might not start implementation immediately. Further, he said that more funds will be made available for the scheme when there is a requirement.
The NHPS, popularly known as Modicare, is a health insurance scheme expected to offer life cover to 10 crore vulnerable families
20 March 2018
The director general of WHO, Tedros Adhanom Ghebreyesus, praised the ambitious plan of the Indian government to pave way for universal health coverage by way of the newly introduced government-funded scheme NHPS (National Health Protection Scheme). The NHPS, commonly referred to as Modi Care, is said to offer health coverage to 50 crore vulnerable Indians.
Ghebreyesus also lauded the success in the elimination of maternal and neonatal tetanus, and yaws. He believes that the government’s idea to increase the healthcare expenditure to 2.5% of GDP by the year 2025 is encouraging. He referred to Modi Care as a priceless gift and stated that it will help create a healthy and safe future for the citizens.
16 March 2018
PM Modi addressed a gathering in his constituency and promised that the government will provide Rs.5 lakh cover per annum through the ‘Aayushman Bharat’ scheme. He added that the underprivileged needn’t worry about medical expenses and that his government will manage the treatment costs through the medical insurance scheme.
PM Modi, at Varanasi, gave out certificates and checks to all those who were provided free houses or cash benefits from government schemes. He launched a development scheme worth Rs.800 crore and also launched the ‘Janshatabdi Express’ that will travel from Varanasi to Patna.
15 March 2018
T.M. Thomas Isaac, the finance minister of Kerala, stated that the health insurance scheme planned for service pensioners and government employees will soon be implemented.
The statement came in response to a submission made by Ramesh Chennithala, the leader of the opposition of the Kerala assembly, who pointed out the delay in the implementation of the scheme. Dr. Isaac made it known that the tender proceedings are in the completion stage and the scheme would be executed soon.
15 March 2018
The Labour Ministry plans to establish a super speciality hospital in each state of the country. This is in response to the Modi government’s plan to magnify the ESI (Employees’ State Insurance) scheme by offering coverage to 10 crore workers of the country by the year 2022.
Presently, Sanath Nagar in Telangana and Kollam in Kerala each have a super speciality hospital. The ESI scheme provides a range of benefits which include coverage for medical expenses, provision of a death benefit to the worker’s family on his/her death, and provision of cash benefits when the worker is injured or sick.
14 March 2018
CM Raman Singh paid a visit to Bandatola, Kanker district and gave polio drops to children. The Principal Secretary, Aman Kumar and the Forest Minister, Mahesh Gagda accompanied the CM to the village. The CM analysed the reality of application of the development plans chalked out by the government.
The CM learnt that the Patwari was diligent in carrying out her duties. He praised Patwari Ms. Mithileshwari Mandawi and asked her to keep up the good work. He learnt that the villagers have well-constructed toilets, that smart cards have been issued for the Health Insurance Scheme, and that all households have electricity supply. He announced that the health insurance coverage was extended from Rs.30,000 to Rs.50,000 and appealed to the masses to avail the scheme.
Raman Singh’s visit was a part of the ‘Lok Suraj Abhiyaan’ being conducted throughout the state of Chhattisgarh. The Bandtola visit was day 1 of phase 3 of the campaign.
13 March 2018
The Prime Minister of India, Mr. Narendra Modi, reviewed the progress made with regard to the launch of the National Health Protection Scheme, earlier this week. The Prime Minister has also instructed officials to ensure that the scheme delivers the necessary benefits to the weaker segments of society. The scheme will be providing an insurance cover of Rs.5 lakh to each family.
The scheme is expected to cover around 10 crore families from economically-weaker sections of society. Further, Mr. Modi also reviewed the preparations made to deliver comprehensive healthcare services through various health centres in the country.
10 March 2018
Mahatma Jyotiba Phule Jan Arogya Yojana, also known as MPJAY, is a health insurance scheme which is provided by the govt. of Maharashtra to all patients who fall above or below the poverty line. The scheme offers cover for nearly 971 procedures, providing health insurance cover worth Rs.1.5 lakh per year, to every eligible family. Following the Budget 2018 announcement, the state’s govt. has begun the process of integrating the National Health Protection Scheme that will provide cover worth Rs.5 lakh to each family. However, the existing health insurance schemes are already riddled with a number of unresolved issues, which include poor participation in rural areas and taluks, lacking awareness about the schemes, and long-distance trips which people have to make in order to avail the scheme and its benefits.
According to a study conducted by Centre for Enquiry into Health and Allied Themes, it was discovered that only 5,952 and 8,775 surgeries have been performed under MPJAY in Gadchiroli and Nandurbar, whereas in Mumbai 2.23 lakh surgeries have been performed. One of the biggest reasons for poor coverage is the stringent criteria that hospitals are required to follow for being empanelled. Another reason plaguing the schemes is excessive paperwork which patients are required to submit in order to avail treatment under the scheme.
9 March 2018
The Union Government of India has decided to provide around 1,100 health insurance benefit packages under the NHPS (National Health Protection Scheme), which is also popularly known as Modicare. The various state governments are yet to arrive at a decision about how to implement this health insurance scheme from 15 August 2018.
Thus, it was reported that in the coming few meetings/consultations, the states will be finalising the implementation models and architecture that can be used. Under this scheme, the Centre will be providing health insurance to about 40% of the population in the country on a cost-sharing basis with various state governments across the country Thus, the central government will be funding 60% of the costs incurred, while the state will be expected to cover 40% of the resulting amount.
9 March 2018
Prudential, an insurance company in the US and Azim Premji, Indian billionaire have united to challenge bidders for a good stake in Star Health and Allied Insurance.
Experts believe that with the introduction of the National Health Protection Scheme (NHPS), the health insurance market will see a surge. This might increase the value of Star from the estimated Rs.6,000 crore. The insurer is believed to have many bidders including Kedaara Capital and WestBridge Capital. Star Health is the only Indian health insurance company that has a 2.36% share in the market. Rahul Garg, a partner at PremjiInvest says that the insurer will see a growth of 20-25% in the next four-five years.
7 March 2018
The Delhi High Court (HC) passed an order on 26 February 2018 stating the need for the Insurance Regulatory and Development Authority of India (IRDAI) to focus on two essential factors of health insurance contracts. One, the need for clarity in exclusions. Broad terms such as ‘genetic disorders’ are mentioned as exclusions. The insurers don’t specify which disorders, in particular, will be excluded from the policy, which gives them the freedom to reject claims as and when they wish. The second factor is the addition of exclusions post purchase of the policy. Insertion of exclusions on the renewal of the policy or during product launches breaches the principle of good faith.
The ruling came in response to a case filed by Jai Parkash Tayal whose claim for treatment of Hypertrophic Obstructive Cardiomyopathy was rejected by United India Insurance Co. Ltd. The HC judgement was in favour of Tayal.
6 March 2018
‘Arogya Karnataka’, the universal health coverage scheme designed by the state government will be enforced; and private hospitals have to transition from the existing schemes to the new scheme.Empanelment for ‘Arogya Karnataka’ is expected to start today, the 5th of March. Hospitals under each of the existing schemes – ‘Rashtriya Swasthya Bima Yojana’, ‘Yashasvini’, and ‘Vajpayee Arogyashree’ have been given specific dates within which they are required to be empanelled in the new scheme.
While Dr. Madan Gaekwad, Vice-President of Sagar Hospitals stated that they will treat emergency cases at their hospitals but ask for a referral letter if an elective procedure needs to be conducted, Dr. Govindaiah Yatheesh, medical superintendent of Apollo Hospitals is of the opinion that the idea of referral letters from the government is not feasible.
5 March 2018
The labour ministry of India has proposed a social security system which will provide various benefits to more than fifty crore worker. The system will provide retirement, health, old age, disability, unemployment and maternity benefits. The scheme will be divided into four tiers and will be implemented in three phases over a span of 10 years meant solely for people falling below poverty line.
The first phase which is expected to cost close to Rs 18,500 crore will see all the workers get the bare minimum benefits from the scheme which will include retirement and health benefits. Upon its completion, the second phase will be activated which will see unemployment benefits added to it while the third phase will have other welfare benefits being added.
It is understood that the scheme will benefit close to 10 crore poor families with each of them being provided Rs 5 lakhs per year. The scheme in future is expected to help more than 50 crore families and is likely to become of the world’s largest government funded health protection scheme.
3 March 2018
A case was filed by a policyholder whose claim was rejected by the health insurer on grounds that the treatment was for a genetic disorder which was mentioned as an exclusion in the policy. The Delhi High Court passed the judgement in favour of the policyholder.
The judgement also directed the IRDAI (Insurance Regulatory and Development Authority of India) to revise the exclusions mentioned in insurance policies and make sure insurance companies don’t reject claim requests on grounds that it was due to a genetic disorder. Insurance policies can be bought with much ease but it is the claim settlement that has too many hassles. The judgement pushes insurers to bring about transparency in the insurance contracts.
1 March 2018
PM Narendra Modi and the President of BJP, Amit Shah, addressed the Mukhyamantri Parishad (Council of Chief Ministers) and asked them to implement welfare schemes, especially in the rural areas so that the party can benefit from it during the 2019 elections.
Among plans for development of rural electrification, housing, and minimum support price for farmers, Modi asked the CMS to ensure effective implementation of the health care scheme in every state. The Centre, on February 1st, announced the introduction of NHPS (National Health Protection Scheme) that will provide health insurance to 10 crore vulnerable families in the country.
The elections that were conducted recently indicated that BJP’s hold over the rural areas was not good. Hence this year’s aim is to reach out to the underprivileged and address their concerns to strengthen the party’s support.
1 March 2018
The Centre announced, during the 2018 budget session, that it will introduce the National Health Protection Scheme and cover the lives of 10 crore families. The coverage the scheme has proposed to offer is Rs.5 lakh per annum per family.
The Congress released its election manifesto in which it stated that it will enhance the cover proposed by the Centre. The manifesto that constituted of 20 pages was released a day before the last day of campaigning for the approaching state elections in Meghalaya. It promised to increase the Rs.5 lakh coverage if it is re-elected in the state.
28 February 2018
A senior NITI Aayog official said that they consulted Nandan Nilekani with regard to the NHPS (National Health Protection Scheme), dubbed Modicare, a healthcare scheme that requires large-scale IT infrastructure. Nilekani helped execute the Aadhaar idea and has agreed to assist in the IT infrastructure development for Modicare.
The Modicare scheme was made known to the public on the 1st of February, 2018 during the 2018 Union Budget session. The proposed scheme is planned to have Rs.5 lakh cover per year per family. The premium estimated is Rs.900 to Rs.1,000. While the Centre provides 60% of the funds, the state will provide 40%. The Centre will, however, provide 90% of the funds for special cases.
24 February 2018
A leading lottery distributor in Kerala suggested that lotteries can be utilised to create funds for the National Health Protection Scheme (NHPS), also known as Modicare. The CEO of Sugal and Damani Group, Kamlesh Vijay pointed out to the Prime Minister how the Kerala government has planned to mobilise funds from the Kerala lottery for the Comprehensive Health Care Scheme.
The NHPS has been proposed to provide a Rs. 5 lakh medical coverage for 10 crore vulnerable families. The precise amount of funds required has not been estimated by the government. Vijay stated that lotteries will fetch Rs.10,000 crore to the Kerala exchequer. He estimates the funds that can be created from lotteries across the country can be between Rs.35,000 crore to Rs.50,000 crore.
22 February 2018
The state government has decided to design standard treatment guidelines for public and private hospitals. Government medical colleges will be granted administrative autonomy to enable smooth flow of administrative procedures. Giving a boost to research in medical colleges is yet another plan. The state also wishes to strengthen vigilance systems to help curb corruption.
21 February 2018
The National Health Protection Scheme (NHPS), announced at the 2018 Union Budget session, aims to cover 10 crore vulnerable households, which constitute 40% of India’s population.
The premium for the health care scheme which has promised to provide Rs.5 lakh coverage per year per family is said to be between Rs.900 and Rs. 1,000 according to a senior official of NIYI Aayog. With the Centre bearing 60% of the cost and the state bearing 40% rest of the costs, the government will cover the complete premium amount of Modicare.
21 February 2018
On February 1st, during the Union Budget 2018 session, Arun Jailtely announced what is said to be the largest healthcare scheme in the world – National Health Protection Scheme, also known as Modicare. It aims to cover 50 crore vulnerable families by offering Rs.5 lakh health coverage for each family.
The Chief Minister of West Bengal, Mamata Bannerjee opted out of the scheme stating that their own state medicare scheme covers 5 million people. Karnataka, too, does not wish to adopt the Centre’s scheme for similar reasons. The state is all set to announce a medicare scheme on the 26th of February. The State Health Minister, Ramesh Kumar, stated that the state doesn’t intend to have a maximum coverage limit and called the NDA’s healthcare scheme a “pretension”. He also stated that the Centre may wish to copy Karnataka’s medicare scheme that will be announced soon.
20 February 2018
Standalone health insurance firm Apollo Munich has come out with a new ad campaign in an effort to highlight the features and benefits of the Health Wallet plan, which was recently rolled out by the insurer under a new category of insurance called ‘WINSURE’. The company’s brand ambassador, Farhan Akhtar, will be starring in these ad campaigns. These 20-second ad campaigns will be leveraged on popular social media platforms, like Facebook, YouTube, Twitter, etc., and also on traditional mediums like the radio and television.
The revolutionary health insurance policy will cover expenses that are usually excluded from most health insurance policies. Thus, this plan will cover OPD expenses, out-of-pocket expenses, and will also provide policyholders a reserve benefit that they can use to pay for their co-pay or deductible charges.
10 January 2018
The Finance Ministry recently announced that it had cleared a Foreign Direct Investment (FDI) proposal to the tune of Rs.532 crore in December 2017. The proposal, which was related to Metaffinity, was approved by the Finance Ministry to make an investment in India-based insurance firm Religare Health. The insurance company had asked for approval for investment from foreign investors. The proposed percentage of investment was 49% by international investors Pantheon-HK Project Universe and CPPIB (Canada Pension Plan Investment Board).
5 January 2018
In an effort to spread awareness of exactly how widespread illnesses and diseases have become and how expensive they are to treat, Religare Health Insurance has created a YouTube video, which highlights the importance of financial planning and having an adequate health cover. The video has received more than 9 million views within one day of being uploaded.
The company created this campaign after they observed that most health insurance buyers were of a relatively older age. By way of this video, the insurer is trying to spread awareness of the increased incidence of critical illness, among the youth of the country.
29 December 2017
In a move to provide emergency cover for accident victims, the Maharashtra government has proposed a Rs.250 crore budget for medical emergency insurance. The insurance covers acid attacks, vehicle accidents, building collapse, etc. The proposed insurance plan is said to cover expenses for all accident victims. The victims will be able to avail Rs.30,000 for immediate treatment. The plan will be named after Bal Thackeray, the founder of Shiv Sena. The scheme allows the victim to skip the formality of furnishing personal details when being hospitalised. This helps avoid delay in the time of the emergency. This plan is also applicable to non-residents of Maharashtra who meet with accidents within the state limits. Ambulance service will be provided to take the victim to the nearest hospital.
29 December 2017
Taking inspiration from the existing similar schemes that are being successfully run in Karnataka and Delhi, the Maharashtra Govt. has announced its plan to introduce health insurance schemes for medical emergencies arising due to road accidents or heart attacks. This noble plan has been launched with the objective to save lives of all those who may be victims to such misfortunes. The estimated budget to cover the scheme’s first financial year is close to Rs.200 crore.
Under the tentative plan, the state government is proposing to bear treatment costs of up to Rs.30,000 for a period of 24 hours from the time of the accident at a public or private hospital. The proposal for this scheme is still being considered and yet to receive the green signal from the chief minister.
The mandatory clause under this scheme which required the submission of an ID proof for hospitalization, has been done away with, as it may cause delays in the treatments for emergency cases. This scheme, if it comes into existence, will also provide cover and emergency ambulance services (108) to residents who hail from outside the state. The ambulance service has been enlisted in order to ensure that the stricken victims can be transported to the nearest medical facility in the shortest time.
Dr Satish Pawar, Director of Health Services said that that after the injured victim has been stabilized, they will be provided the option to either continue their treatment at a private hospital at their own cost or get transferred to a government hospital and avail free of cost treatment.
28 December 2017
New India Assurance (NIA) recently made news when it announced that it would insure nearly 4 crore Indians under a health insurance project named Bhamasha Swasthya Bima Yojana.
Yet again, NIA is in the news and this time it has bagged the aviation insurance decree for Air Deccan.
Air Deccan was a pioneer in cheap air travel plan for quite some time. It has now returned to the market with a regional connectivity plan. It aims to connect even the smallest of cities throughout the country.
Apart from Air Deccan, New India Assurance provides aviation insurance to Go Air, Air India, Spice Jet, Indigo, etc.
27 December 2017
Recently, the insurance regulator had commissioned a working group to study the innovations involving the use of wearable and portable devices, in the Indian life and health insurance sectors. These devices can measure one’s fitness levels and can help the user lead a healthier lifestyle.
The Insurance Regulatory and Development Authority of India (IRDAI) has already accepted the role of wellness and preventive habits in calculating risk. As a result, under the new regulations issued last year, health insurance providers can reward customers by way of premium discounts for maintaining a healthy lifestyle. The current committee formed by the IRDAI is looking to study the impact these wearable devices on insurance pricing.
26 December 2017
It is reported that five companies, including one financial services company, three general insurance firms, and one global private equity fund, have been shortlisted to buy Star Health Insurance. Star Health & Allied Insurance is the largest standalone health insurance company in the country, and a deal could value the firm at Rs.6,500 crore.
The companies shortlisted include HDFC Ergo, ICICI Lombard, Bajaj Allianz, private equity firm Warburg Pincus, and Hero Fincorp. The promoters of Star Health Insurance received 12 bids from various companies last week. The sellers have established Rs.5,500 crore as the floor price and the shortlisted companies will have to bid for an amount over the floor price.
22 December 2017
A joint study by FICCI and EY has revealed that while the healthcare sector in India has been a key area of development, health insurance coverage in the country still remains below par and is also considered expensive by many people. Thus, health insurance firms in the country have been trying to expand the coverage, reduce cost of policies, and leverage new technology and distribution models.
Central and State Governments have also launched several initiatives to improve the public’s awareness of health insurance. To this end, Mr. Sandeep Patel, Co-Chair, FICCI Health Insurance Committee and Managing Director and CEO of Cigna TTK Health Insurance said that it is essential to understand the reasons that drive purchasing behaviour among consumers.
21 December 2017
The management of HDFC (Housing Development Finance Corporation) has approved a 5% stake sale in an effort to raise Rs.13,000 crore. The equity shares will be sold to institutional investors. With the amount raised through the stake sale, HDFC will continue to maintain their 21.01% stake in HDFC Bank and will also be foraying into the health insurance, real estate, and affordable housing sectors. HDFC is looking to foray into health insurance through its subsidiary HDFC Ergo or via acquisitions. HDFC had previously raised funds in 1994 and 2007 in order to maintain their stake in HDFC Bank.
20 December 2017
Mr. Parvez Ahmed, the CEO and Chairman of J&K Bank, announced that they will be launching a preventive comprehensive health check-up campaign for all company employees. The plan will be launched in association with Bajaj Allianz General Insurance. The two-day campaign will include initiatives to improve employees’ awareness of heart ailments, a free health check-up, and medical tests. The bank has been encouraging all its employees to make use of this campaign and to keep a close check of their health in an effort to prevent health issues in the future.
19 December 2017
FICCI-KPMG, in a recent report, emphasised the need for a Health Savings Account scheme to meet the complete coverage needs of policy buyers. The report also added that this health insurance scheme should be managed by a government appointed body or should be privately managed by insurance firms with centralised fund management.
The Indian healthcare sector is mostly driven by out-of-pocket expenses, with only about 27% of the country’s population having a health insurance cover. The remaining 73% of the population remains uninsured. Thus, the creation of a Health Savings Account is very important to increase the penetration of health insurance to all parts of the country.
19 December 2017
Health insurance firm Aditya Birla, which completed a full year of operations recently, is now looking to expand their operations to 100 cities over the course of the coming two years. The insurer currently has a presence in around 34 Indian cities. The company, after the first year of operations, has reported a total premium collection of Rs.150 crore. Aditya Birla Health Insurance currently has five bancassurance partners and around 12,000 agents, giving them a wide reach. The insurance provider is also expecting to break-even in less time than their industry peers.
15 December 2017
The launch of the much-awaited universal health insurance scheme will most likely be announced as part of the 2018 Union Budget. It is reported that the government is very keen about the launch of this scheme and has met with several insurance officials for suggestions on how to design the scheme. While the policy was announced by the Finance Minister, Mr. Arun Jaitley, the design of the policy, key features, and the allocation of states for each insurance firm has not yet been decided.
It is, however, likely that public-sector and private-sectors insurance companies will be covered. While the existing Rashtriya Swasthya Bima Yojana (RSBY) offers a sum insured of Rs.30,000, the new scheme will likely have a higher cover with a lower premium rate. The RSBY scheme was specially designed to provide a health cover to BPL households and was launched in the year 2008. Currently, not many RSBY policies are being issued, thus paving the way for the launch of the new scheme.
14 December 2017
Health insurance firm Apollo Munich has announced that they will be targeting a 30% increase in new business premium collection by the end of the current fiscal. This will mean that the insurer will be targeting a collection of Rs.1,700 crore in FY18, against Rs.1,300 in FY17.
The company recently launched a new health insurance plan called ‘Health Wallet’, which will be providing policyholders a cover against out-of-pocket expenses that they might have to incur as a result of purchasing medicines, undergoing diagnostic tests, vaccinations, dental treatments, purchase of contact lenses/spectacles, etc.
13 December 2017
Health insurance firm Apollo Munich has announced that they will be targeting a 30% increase in new business premium collection by the end of the current fiscal. This will mean that the insurer will be targeting a collection of Rs.1,700 crore in FY18, against Rs.1,300 in FY17.
The company recently launched a new health insurance plan called ‘Health Wallet’, which will be providing policyholders a cover against out-of-pocket expenses that they might have to incur as a result of purchasing medicines, undergoing diagnostic tests, vaccinations, dental treatments, purchase of contact lenses/spectacles, etc.
13 December 2017
On Monday, a day prior to Universal Health Coverage Day, Health Minister J P Nadda said that the government is devoted to promote Universal Health Coverage in India.
Nadda launched a mobile application that would assist medical attendants, to conduct complex deliveries on the outskirts. This, in turn, will ensure safe and quality treatment. At the event, he promised to push the idea of Universal Health Coverage in India.
The National Health Profile (NHP) data compiled by Central Bureau of Health Intelligence (CBHI), however, indicates that 73% of the total population are not covered by any health insurance. Which means, 100 crore out of 135 crore citizens in the country are not covered by any health insurance scheme. Further, the report also states that only a constant 0.98% of GDP is spent on health.
Out of the 27% citizens who have health insurance, 77% are covered by public health insurance companies. On the whole, 80% Indians who do have insurances are covered by government sponsored schemes. Hence, advancement in such schemes would lead to Universal Health Coverage.
12 December 2017
The most recent health report that was prepared by the Central Bureau of Health Intelligence (CBHI) has reported that individuals living in the state of Andhra Pradesh have had to spend the highest amount of money for hospitalisation and related expenses, with people living in urban areas of the state paying between Rs.31,242 and Rs.33,671 on an average.
The report shows that the per capita public expenditure on healthcare has risen from Rs.621 to Rs.973 in 2014-2015. The data also shows that the share of the Centre in the public expenditure of health has declined over the past few years.
12 December 2017
MR T.P. Ramakrishnan, the Labour and Skills Minister, recently said that the state government of Kerala is implementing measures to include individuals working in unorganised sectors into insurance schemes and will also be expanding the working of the Comprehensive Health Insurance Agency of Kerala (CHIAK). CHIAK is a nodal agency that was especially constituted for the launch of the RSBY-CHIS health insurance plans in the state of Kerala.
Overall, around 4,40,779 families have been recently covered under the Rashtriya Swasthya Bima Yojana scheme (RSBY). The scheme had previously covered 34,85,000 individuals. While over 50% of the state’s population have already been covered under the scheme, the Labour and Skills Minister has said that an effort should be made to include more people from deserving categories into the scheme. The minister also added that there would be a special focus on ensuring that claims were cleared and settled without a delay.
11 December 2017
New India Assurance Company Limited has recently announced that they will be executing a health insurance scheme for around one crore families from the economically-weaker sections of society, in the state of Rajasthan. The project is called Bhamasha Swasthya Bima Yojana (BSBY) and around 4 crore people who are covered under the National Food Security Act (NFSA) will receive the benefits of this health insurance scheme.
It is also reported that this scheme is one of the largest in the country considering the fact that it gives a health cover for cashless hospitalisation of about 1,401 diseases, with a limit of Rs.3 lakh for 664 critical illnesses and a limit of Rs.30,000 for 738 general illnesses. The scheme will operated in the state by way of both public and private-sector empanelled hospitals.
The overall insurance premium for this scheme will come up to around Rs.1,200 crore per annum, and the State Government will bear around Rs.1,261 per family. By way of this scheme, the government is trying to improve health indicators, reduce out-of-pocket expenses, and provide financial security against unplanned hospitalisation, thereby bringing-in a healthcare revolution to rural parts of the state.
New India Assurance is one of the leading general insurance firms in India and has a pan-India presence. The insurance firm’s operation are spread across 29 Indian states and 7 union territories. The insurer also operates internationally.
11 December 2017
Standalone health insurance firm Apollo Munich has launched a novel health insurance plan called ‘Health Wallet’. This health insurance plan not only provides a cover against one’s hospitalisation and OPD expenses, but also offers affordability in terms of continuing the insurance plan through one’s later years.
The insurer also offers a ‘Reserve benefit’ with this plan, wherein policyholders can carry-forward their unused reserve amount and in-turn earn a bonus of up to 6%. Policyholders can use the ‘reserve benefit’ offered by this policy to fund their deductible cost and co-pay charges. The benefit can also be used to cover certain out-of-pocket expenses, such as speech therapy, purchase of medicines, contact lenses, and spectacles, vaccinations, dental treatments, etc., which are usually excluded from most health insurance plans.
8 December 2017
The Insurance Regulatory and Development Authority of India’s (IRDAI) decision to allow private equity (PE) funding in the insurance sector has enabled insurance firms to have professional promotes. The regulator will be issuing the final guidelines on private equity funding in insurance, shortly. Thus, by way of these norms, PE investors will have the option of setting up companies through a special purpose vehicle.
In the past, most insurance firms in India have had only corporate players as their promoters with strategic partners. However, in the recent past, certain private firms, such as Digit General Insurance, Acko General Insurance, and the stand-alone health insurance firm Star Health, have had professionals as their promoters.
7 December 2017
Aditya Birla Health Insurance (ABHICL) has crossed its premium collection target and number of lives covered target during the company’s first year of operations since its start in mid-October 2016. The firm is also in the process of launching health insurance products that will provide coverage to alternative medical treatments.
The insurer’s premium income collection for the five months of operation between FY 2016-2017 was Rs.55 crore. Between April and September 2017, the insurance firm collected Rs.96 crore, against a target of Rs.100 crore for the full fiscal year. The insurer has also covered 6.5 lakh lives, against the targeted 5 lakh lives.
Aditya Birla Health Insurance (ABHICL) was incorporated in the year 2015 as a joint venture partnership between MMI Holding, MMI Strategic Investments Ltd., Aditya Birla Capital Ltd., and Aditya Birla Nuvo Ltd. The insurer’s latest health insurance products will reportedly provide policyholders the option to reinstate their sum insured amount in case it is exhausted during the policy term and will also provide coverage to alternate treatments, such as naturopathy, Ayurveda, siddha, etc.
6 December 2017
Private and public health experts will be coming together for a two-day seminar in Maharashtra in an effort to increase people’s awareness about health issues. The seminar starting on Tuesday is the 13th edition of this event and will see health experts holding discussions and delivering lectures on topics, such as the importance of purchasing health insurance, organ donation, rural health in the state of Maharashtra, etc.
Mr. Girish Mahajan, the Medical Education Minister, will be delivering the keynote address on topics related to health and related initiatives undertaken by the government. The state government of Maharashtra has undertaken certain interventions in an effort to improve the health of the state’s tribal population.
5 December 2017
The 2017 Cigna 360° Well-Being Score-India Report has revealed that around 62% of Indians pay for their healthcare and medical expenses from their own savings, highlighting the low penetration of health insurance within the country. The report also revealed that 85% of Indians have a private medical insurance cover, while government schemes account for a mere 7% coverage.
Self-purchased and employer-provided insurance provides coverage to about 13% of the populace, and 15% of Indians are not covered by government or private health insurance schemes/plans. The survey also reported that a growing number of Indians are making use of healthcare apps to monitor and track their health.
4 December 2017
The Union Health Ministry has drafted a framework, called the National Patient Safety Implementation Framework (NPSIF), in an effort to ensure patient safety while they undergo any medical treatments/interventions. The framework is about surgical care, safe drug dispensing, safe childbirth, blood safety, medication safety, medical device safety, bio-medical waste management, etc.
The ministry has also proposed setting up a digital grievance system and toll-free helpline numbers for patients to use, if the need arises. In addition, the draft has proposed that patient safety concepts and principles should be incorporated in the Public Health Act, and that patient safety under different health insurance schemes should be streamlined.
29 November 2017
The Muthoot Pappachan Group has recently launched a new group health insurance scheme called ‘Health Guard’, which will be made available to all their customers. A few benefits offered under this scheme include reduced waiting periods, option to avail health checks every 2 claim-free years, over 140 day-care surgeries and treatments, education fund for children if the policyholder passes away due to an accident during the policy tenure, etc.
28 November 2017
The latest amendment made to the Karnataka Private Medical Establishment (KPME) Bill has come as a huge relief to the poor and middle class. Under the new scheme, the Karnataka government will bear the complete medical and hospital expenses of patients who are from Below Poverty Line (BPL) families and undergoing prolonged treatment in private hospitals. The state government will also cover 30% of the medical and hospital expenses, for patients of Above Poverty Line (APL) families, in case of their death in private hospitals. This amendment was made as a measure to reduce the stress on patients and families from APL and BPL when they are unable to afford the necessary medical treatment on time. The new scheme also resolves all the negative feelings and doubts that came with the recently added clause, which states that private hospitals should not insist on the family clearing the medical bills to release the patient’s body. In addition to the new scheme, the state government will also be imposing fines on private hospitals for unwanted medical tests, overcharging, etc. The health minister R Ramesh Kumar also confirmed that the government is all set to introduce a new health plan called the Universal Healthcare Insurance scheme which will benefit about 1.43 lakh BPL and APL families of the state.
27 November 2017
Star Health has received around 12 bids from buyers interested in purchasing Star Health Investments’ stake in the health insurance company. A few investors who have shown an interest include PremjiInvest, Kedaara Capital Advisors LLP, Singapore-based Temasek Holdings Pvt. Ltd., Bain Capital LP, Carlyle Group, Warburg Pincus LLC, ICICI Lombard General Insurance, HDFC Ergo General Insurance, etc.
It was reported that that bids submitted ranged between $850 million to $1 billion (Rs.5,400 – Rs.6,400 crore). The firm’s investors have hired Kotak Investment Bank to find a buyer. Star Health Insurance, which was established in the year 2006, is currently the largest independent health insurance firm in the country.
24 November 2017
As per the National Family Health Survey (NFHS) 2015-2016, around 75% of the households that were surveyed within Coimbatore have a minimum of at least 1 family member with an active health insurance cover. Growing awareness about the need for healthcare, increased per capita income, and financial planning can be attributed as a reason for the same. In comparison, households that have an active health insurance policy in metro cities like Delhi, Bangalore, Hyderabad, and Chennai were comparatively lesser.
23 November 2017
Magma HD General Insurance is planning to launch an insurance cover that is specifically catered towards women who undergo infertility treatments by way of In-Vitro Fertilisation or IVF. Infertility treatments, which are increasing in number, are extremely expensive in India. The average cost for IVF treatments range between Rs.1.5 lakh to Rs.3.5 lakh based on one’s location.
Magma HDI, which is a joint venture between Magma Fincorp and Germany-based HDI Global SE, is also launching a premium policy plan which will cover bariatric, lasik, and psychiatric treatments. It is reported that these insurance policies will come with a waiting period of three years.
21 November 2017
Mr. Raghubar Das, the Chief Minister of Jharkhand, said that the state government’s primary priority is to provide immediate medical treatment to people and reduce the overall death rate in the state. It is also reported that around 329 ambulances will be on road by March 2018. By way of the new initiatives and recently launched health insurance scheme, the state government is aiming to provide healthcare services to marginalised sections of the state.
The state government will also be providing ambulances to marginalised and remote areas of the state for emergency medical services. The new ambulance facility will be launched in areas such as Gumla, Lohardaga, Palamu, etc. by December 2017. Further, in an effort to have more working medical professionals at all times of the day, doctors and nurses in the state will be provided a night shift allowance.
21 November 2017
Magma HDI General Insurance, which is a joint venture between HDI Global SE and Magma Fincorp, has launched OneHealth, a new health insurance policy. This policy will cover expenses incurred as a result of medical conditions, including lifestyle diseases. The new health insurance policy comes with a range of additional benefits, such as a free yearly health check, restoration benefit, cumulative bonus for every claim-free year, income benefit, etc. The product comes with 4 variants, with maternity benefits being covered under some of the variants. Policy buyers will have to opt for a sum assured between Rs.2 lakh and Rs.50 lakh, and the resulting premiums will be calculated as per the policy buyer’s location.
17 November 2017
Raghubar Das, the chief minister of Jharkhand, announced that the Chief Minister Health Insurance Scheme will be launched on 15 November in Ranchi, and state-wide on 28 November. Up to 57 lakh families are expected to be covered by this scheme. As per this scheme, Rs.50,000 will be allocated to secondary medical care, while Rs.2 lakh will be allocated to special medical care. The state government is also looking to improve the health/medical infrastructure in the state by setting up new multi-bedded hospitals and rolling out a fleet of new ambulances for the convenience of people.
13 November 2017
Twelve firms have submitted their offers to buy Star Health & Allied Insurance which is India's biggest independent health insurance provider. The value of Star Health & Allied Insurance in the market today is around Rs.6,000 crore. Warburg Pincus and Bain Capital are just two out of the 12 firms that have offered their bids for Star Health & Allied Insurance. The last day to submit all the bids was November 6.
The bidding is being managed by Mizuho Securities, Kotak Investment Bank, and Evercore Partners. Star Health & Allied Insurance is using this bidding as part of their plan to provide an exit strategy to their present investors. Their present investors consist of a global investor like Apis (private equity firm), Tata Capital, ICICI Venture, and Sequoia Capital.
8 November 2017
The revenues of the healthcare sector are expected to grow at the rate of 15% per annum, during the coming three fiscal years due to the rapid increase of health insurance coverage by way of government-sponsored schemes and products. While increasing demand will lead to expenditure, cash flow from other stable existing operations will support the credit profiles.
The number of individuals having some sort of a health insurance coverage has increased to 42 crore over the past three financial years. The increasing demand of health insurance is due to the changing lifestyles of people, rising awareness of health, and the increasing age of the population.
7 November 2017
Apollo Munich Health Insurance was awarded the 21st Asia Insurance Industry Awards in the ‘General Insurance Company of the Year’ category. The firm was recognised for their market leadership, services, customer satisfaction initiatives, product innovation, exceptional business growth, etc. The insurer is the first standalone health insurance firm in the Asia-Pacific region to win this award.
Apollo Munich Health Insurance, which is a joint venture between the Apollo Hospitals Group and Munich Re Group, has accomplished several firsts in the health insurance industry since its inception. The company was the first to offer benefits such as lifelong renewability, portability, a standalone dengue plan, multiplier and restore benefits, no claim-based loading, and no sub-limits, to customers.
6 November 2017
New India Assurance (NIA) was nationalised in the year 1974, and is one of the largest and most preferred general insurance companies in India, in terms of the domestic gross direct premium, net worth, number of branches across the country, and profit after tax. The company’s Rs.9,600 crore IPO (initial public offer) was fully subscribed on Day 1. The insurer is selling its shares at a price band of Rs.770-Rs.800.
The portions that were reserved for retail investors, qualified institutional buyers (QIBs), and non-institutional investors were oversubscribed by 1.5%, 158%, and 2%, respectively. New India Assurance has been a market leader in almost all segments, such as fire insurance, health insurance, marine insurance, etc. The company has a wide reach across the country with 2,452 offices and 68,389 agents. The insurer also operates in 28 countries abroad.
6 November 2017
Smart Super Health is a health policy recently introduced in the market by Bharti AXA General Insurance. Keeping the rising medical costs and needs of Indian consumers, this new plan comes with some noteworthy features.
Smart Super Health is designed to serve a broader public and can cover up to four family members at a time other than the policyholder. To avail an individual policy, the entry age ranges from 5 years to 65 years for adults, whereas for children it ranges from 91 days to 5 years which can be availed if either parent is getting insured under this plan. The policy provides the consumer the choice to avail the plan for a period of 1 to 3 years depending on the consumer's requirements.
This policy also provides the customer with several options to choose from when buying as well as renewing the policy, which means that a customer has the authority to modify the policy as per their growing requirements. There is also no restriction on room rent, which means that a patient is allowed to choose any room at the hospital when being treated.
Smart Super Health also covers expenses for inpatient treatment for fringe medicine that have been recognised by the Government, like Unani, Ayurveda, Naturopathy, etc. The plan also covers air transportation in case of an emergency from the site of the emergency to the nearest hospital. This new health policy also covers the organ donor expenses.
3 November 2017
The Mukhyamantri Swasthya Beema Yojana Scheme will be launched in Jharkhand on 15 November 2017. The Chief Minister, Raghubar Das, has announced that all preparations and formalities are to be completed by then. It is reported that over 57 lakh families stand to benefit from this scheme. The Chief Minister also announced that the scheme will be publicized properly and that all government hospitals will be enlisted. As per the scheme, Rs.2 lakh has been provisioned for special care, Rs.50,000 for secondary care, and Rs.30,000 for senior citizens. This will be a cashless systems, and beneficiaries will also be given cards.
9 October 2017
Standalone insurance firm Apollo Munich and life insurer HDFC Life have come together to launch the Click2Protect Health policy, which will have features of both a life cover and a health cover. The two insurers are also exploring avenues to launch more such combination products in the future. It was also reported that policy buyers purchasing the Click2Protect Health policy will be eligible to receive a 5% discount on the premium.
As per this policy, the minimum sum assured for the life insurance component is Rs.10 lakh, with no limit on the maximum sum assured. For the health insurance component of the policy, the maximum sum assured is Rs.50 lakh, and can be increased to Rs.1 crore if the individual has two claim-free years. The two companies are also looking to collaborate on upcoming product research. The insurers will use both their distribution channels to release the product.
6 October 2017
SBI Life Insurance was trading at Rs.693 per share, which is 1% below the company’s IPO issue price of Rs.700 apiece. The firm had previously made a strong debut by listing at Rs.735 per share, against the issue price of Rs.700. The firm’s stock was down by 6% from its listing high of Rs.738, which was hit on the very first day of listing.
While about 85% of SBI Life’s Rs.8,400 crore IPO was subscribed by institutional investors, the high net worth individual (HNI) and retail portions were not subscribed fully. Several analysts and brokerages had advised clients to subscribe to the firm’s offering as a long-term investment option. The company has been banking on its ULIP business, which comes with lesser requirement of capital, lower regulatory risk, and long-term opex business. However, the downside is that it is also heavily dependent on the performance of the capital market and also has lower margins.
5 October 2017
India’s largest reinsurance firm, General Insurance Corporation of India (GIC Re), is expecting to raise a sum of Rs.11,372 crore, via its IPO. The reinsurer has fixed a price band of Rs.855 – Rs.912 apiece. The firm’s stocks will launch on 11 October and will close on 13 October. The minimum bid lot is 16 shares, and more bids can be purchased in multiples of 16, if required.
The company’s issue will be third largest initial public offering (IPO), after Reliance Power and Coal India, to hit the market. Further, GIC Re is also offering a discount of 5% to eligible company employees and retail investors. The reinsurer’s gross premiums for FY17 was Rs.33,741. The company also reported a profit of Rs.3,140 crore, during the same period. The firm’s gross premium and net profit grew at a CAGR (compounded annual growth rate) of 48.65% and 4.24%, respectively, between FY15 to FY17.
5 October 2017
Standalone health insurance companies, i.e., companies that focus solely on a single line of business, are set to grow at a 25% rate, in the next few years. The market size of such companies is expected to touch Rs.20,000 crore by the year 2020. It is reported that the gross direct premium for all insurance companies in this sector has increased from Rs.2,940 in FY14-15 to Rs.4,151 in FY15-16.
Standalone health insurance firms in India include Star Health and Allied Insurance, Max Bupa Health Insurance, Cigna TTK, Apollo Munich Health Insurance, and Religare Health Insurance. Since only around 27% of India’s population has a health insurance cover, these standalone health insurance firms can stand to gain by serving the remaining unsecured health insurance market in India. In addition, the dependence on private healthcare facilities and increasing medical costs are another reason for these firms to grow.
4 October 2017
General insurance firm HDFC ERGO will soon launch a worldwide health insurance cover for Rs.2 crore. The insurance policy will cover treatments in both India and abroad. The product has already received regulatory approval, and is likely to be launched in the coming few weeks. The company’s motivation to launch the product was that individuals were seen taking their health seriously from a young age.
It was reported that the average age of HDFC ERGO policyholders, in the health insurance division, is under 45 years. High-value health insurance products were also seen to be in demand among certain segments of the population. Since a medical treatment with surgery usually costs between Rs.50 lakh to Rs.70.lakh in the US and Europe, having a higher-ticker insurance product will help many.
28 September 2017
SBI Life launched its IPO in an effort to raise Rs.8,400 crore. By the last day of bidding (22 September), the company’s IPO was oversubscribed by 3.58 times. The insurer is expected to announce the allotment by 27 September 2017. SBI Life’s IPO is one of the largest IPOs to be launched in the last seven years. The life insurance firm received around 29.5 million bids, which was 3.58 times over the company’s offering of 8.8 million shares.
SBI Life Insurance’s key joint venture partners, BNP Paribas Cardif and State Bank of India, are selling a 4% and 8% stake in the company, respectively. The price band for each share was fixed at Rs.685 – Rs.700 apiece, by the insurer. Other insurance companies that have filed for IPO include HDFC Standard Life, New India Assurance, and GIC-Re. All three firms together are expected to raise over $4 billion through their IPOs.
25 September 2017
Insurance firm Apollo Munich has opened new branches in Bhopal and Indore. The company is expecting to double their customer base in these cities. The insurer is also planning to scale its operations by opening 55 new branches in various states across India. The company is one of the market leaders in the health insurance sector, and has a claim settlement ratio of 93%, against the industry standard of 89%. The insurer also works with more than 4,500 hospitals across India, to guarantee hassle-free service to customers.
22 September 2017
Insurance firm Apollo Munich, which a joint venture between Munich Re and the Apollo Hospitals Group, recently completed 10 years in the business. The company is now looking at its Tier II capital to raise funds, and it is reported that this capital may be raised based on time-to-time requirements, and no new infusion of equity is expected.
While the premium collection for the financial year 2017 was Rs.1,300 crore, the firm is targeting a collection of Rs.1,700 crore in the current fiscal. The insurer is also expecting to see a growth of 25-30%, in the coming few years. Apollo Munich has reported that around 75-80% of their business comes through retail customers, and the remaining business comes from group and corporate accounts.
The insurer is also offering attractive benefits and solutions under their Wellness area. The firm is also focused on reinventing and delivering innovative offerings to customers. Individuals are encouraged to lead a healthy lifestyle, and people who walk 10,000 steps a day are offered an attractive renewal discount of 8%, via the app.
12 September 2017
A new health insurance policy, the Extra Care Plus, has been launched by Bajaj Allianz. It is a top-up plan that offers a cover for maternity expenses and pre-existing diseases, with a 12-month waiting period only. The policy also comes with an Aggregate Deductibles feature that will enable the policyholder to make multiple claims, through the policy term, which will then be clubbed together to surpass the deductible amount and receive the claim payout.
The policyholder can avail the benefits accorded by this plan, even if his/her expenses are over the aggregate deductible limit, provided it doesn’t exceed the sum insured. If the policy is purchased with a cover of Rs.10 lakh and a deductible of Rs.5 lakh by an individual between 31-35 years, the premium will come up to Rs.1,930 (excluding taxes). And, if the same policy is purchased by an individual between 36-45 years, the premium will come up to Rs.2,193 (excluding taxes).
7 September 2017
HDFC ERGO has partnered with ItzCash, a payments solutions firm, to have general insurance products up on its platform. The policies on offer will comprise of health insurance, motor insurance, fire insurance, and auto insurance products. This strategic tie-up will help users complete the entire policy-buying process, starting from filing the insurance application form to making the necessary payments, right on the platform. This will lead to an eradication of human error and real-time customer service. Users will also have the option to make premiums payments at ItzCash outlets, across the country. This initiative will greatly help increase HDFC ERGO’s reach, especially to individuals residing in Tier II and Tier III towns.
1 September 2017
Cigna TTK Health Insurance is a joint venture between Cigna Corporations and the TTK Group. Since Cigna Corporations has hiked its stake in the insurance firm from 26% to 49%, the company is all set to expand its business, upgrade its technology, and increase its distribution network, all to the tune of Rs.114 crore. The insurer is also planning to increase the number of branches from 16 to 21 by the end of 2019, in order to reach customers in Tier II and Tier III towns.
This business expansion will also see the number of agents increasing from 19,000 to 25,000-30,000, in the future. The firm currently has a 900-employee workforce, and will soon be increasing this number by hiring 300 new employees. The insurance firm is currently focusing on a multiple network distribution model. The insurer will also be launching a new insurance product called the ProHealth Select Plan, which will include a host of beneficial features, such as healthy rewards, an inflation shield, reassurance benefits, and more.
28 August 2017
Star Health Insurance is in the process of launching an insurance product specifically catered to people already suffering from cancer. It is reported that the product will be launched as soon as the company has fixed a price for it. The insurer is also planning to introduce insurance products for children suffering from autism, and is currently awaiting regulatory approval for the same.
In order to escalate their growth and meet targets, the company is in talks to raise Rs.200 crore, within the next few months. The company has also re-launched and increased the purchase price of its Family Health Optima policy. The insurer, who collected gross written premiums worth Rs.2,962 crore last year, is targeting a premium collection of Rs.4,000 crore for the current year. The insurer is also looking to open around 20-25 branches shortly, in order to scale its operations.
18 August 2017
India’s public sector general insurer, New India Assurance has launched its health insurance products for individual and families in Gulf countries. The products, which are compliant with Dubai Health Authority (DHA) guidelines, will offer treatment in UAE, with an additional option of travel reimbursement for in-patient treatment at home country. Gold Plus, Diamond Plus and Euromed Silver Plus are the various packages being offered in GCC that cover pre-existing diseases, maternity cover and dental treatment cover. Last year, the company earned AED 285 million in UAE out of which AED 203 million was in Dubai alone. Price is an attractive feature of the health insurance product, said the company especially when DHA has made insurance mandatory, in a phased anner. The company operates five branches in GCC countries.
27 May 2015
Apollo Munich, one of India's leading health insurers, is evidently taking its role as a co-sponsor of the Indian Super League very seriously. It has announced plans to promote soccer among budding players through educational videos on the sport. While physical skill is tried and tested on the field, aspects such as warm-up exercises and techniques can be demonstrated online. Apollo Munich has recognised the potential this method harbors to make training both accessible as well as affordable to the masses.
The health insurer's move to use technology to develop soccer as a sport in India is an innovative way to reach young talent across the country. Initially, the target locations will be Kolkata and surrounding regions. Shooting commences at Salt Lake Stadium and is due for release early next year.
19 November 2014
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