Page 42 - The Insurance Times May 2021

policy holder (individual or group) for pre-existing conditions
and time bound exclusions, from one insurer to another
insurer within the time frame and without any rider.
Contrary, the group policy holder is deprived of portability
as the Group Aggregator (GA) is not evincing any interest
to take up the matter with the concerned for resolution.
This is compelling the policy holder either to continue with
the same insurance company, though not interested, or join
in another company and wait for 2 or 3 years for pre-existing
disease claims. The regulator has to look into this area and
ensure the portability to all policy holders who are
interested.

It is observed that the majority of GAs are not evincing the
is between Rs. 5 to Rs. 10 lakh per annum with cross- desired attention to protect the interests of the group
subsidisation by the respective institutions in case of retired members and not exercising their prudent negotiation skills
employees and with regard to others, it should be done by
with the insurance companies while renewing the policies.
the centre/states.
They are more interested in fee income and dropping the
policy holders like hot potato to the mercy of the insurance
The cost of the health insurance policy mainly consists of
companies.
claims, operating expenses and taxes. On implementation
of GST regime, the tax component has increased from 15%
The argument of insurance players in favour of hike in
to 18% which is a big burden on the policy holders. Health
premium is mainly due to increased claims coupled with
care being a priority subject on the government agenda,
medical inflation. The chief reason for this is not having
taxing the individuals that too on purchase of health
uniform rate for each ailment or disease and the treatment
insurance policies is not fair. Government need to revisit its
cost varies from hospital to hospital within a city/town.
stand and initiate steps to bring down GST to zero forthwith
since the senior citizens need it the most. Further, it is a well-known fact that private hospitals are
charging extra to card holder compared to normal cash
payment. Thus, monetary cap on ailments and uniform
Since health policies are subjected for renewal every year,
it is the responsibility of the insurer to inform the changes billing with or without health card is the need of the hour.
in premium or any other terms & conditions of the policy, The Gen-S segment is known for their hard work, sacrifices,
to the insured well in advance. Conversely, the insurance devotion and dedication to the family, organisation where
companies are communicating the revised premium rates they worked as well as to the society. It is not out of place
just before the due date of the policy, causing inconvenience to mention that the senior citizens are the most law-abiding
to the insured. Thus, the regulator has to ensure that the lot and have been genuinely paying taxes all through the
policy holder receives communication from the insured years for the nation building. In the process, they have
minimum three months before the due date to enable him/ exhausted all their energies and resources and are left with
her to take informed decision either to renew the policy or little income to lead their second innings independently.
to switch to other insurance companies with seamless
portability. "Respect Elders", though has a resonance in various forums,
but very little is done in letter and spirit. The Gen-S group is
Levying premium based on the age of the policy holder is to forced to look up to the Government, Regulator and former
be scrapped forthwith especially in case of group policies. employers not for any freebies or charity but for deserving
The revision of the premium, if any, should be reasonable health coverage to continue their journey in their twilight
and uniform across all age groups. years with peace and dignity. The stakeholders need not be
reminded that this moral act is the least tribute that can
As per IRDAI guidelines, it is the responsibility of the be paid to the elders who were once born young. Hope, good
insurance companies to transfer the credit gained by the days are ahead for Senior Citizens!!! T

42 The Insurance Times, May 2021