‘Health insurance claims ratios are cause for concern’
‘Health insurance claims ratios are cause for concern’mumbai Updated: Nov 18, 2011 01:00 IST
Q. The health insurance industry has been growing in the past few years with several private players. With portability announcement, what changes do you expect?
A. Health insurance industry has been growing at an appreciable rate in the past few years. The PSUs still have the lion’s share of 60%, while the private players have the balance 40% in health insurance. With the portability announcement we do not expect any immediate change or flight of insured from one insurer to another. This has been mandated to facilitate cases where the insured chooses to migrate for compelling reasons.
Q. How will customers benefit with regard to waiting period for pre-existing illnesses and no claim bonus transfers?
A. Portability has been brought in by the regulator only to benefit the customer. This now ensures that benefit of period already served under an existing policy is given to the insured and one does not have to start afresh for serving the pre-existing condition, waiting period and specific illness exclusions.
Q. What is the claim settlement ratio and how is the industry faring?
A. Health insurance claims ratios are a cause of concern. From a ratio of 112% it had come down to 108% last year and now to 99%. But the total number of grievances reported for the industry in 2009-10 was 2076 out of total number of more than 2 crore.
Q. With medical costs rising multifold in the past few years, what should a customer do?
A. It is advisable to take a health insurance policy at an early age when one is in good health. It is important that the coverage is adequate to take care of rising medical costs. SL Mohan, secretary general, Insurance Council, an umbrella body of 25 private and public insurance companies