Page 14 - Life Insurance Today FEBRUARY 2016

tion of healthcare protection from being a luxury Research among the poor indicated that the follow-
or unaffordable to one that is necessary and to be ing benefits are mostly desired to be included -
availed. Hospitalization service;

e) Even under the existing rules on premium payment Outpatient treatment (OP);
it would be possible but not practicable to collect
Re. 1 per day from the beneficiaries. The difficul- Treatment for chronic ailments;
ties would lie in the following areas -
1. The prohibitive cost of collection; Maternity care;

2. Reconciliation & accounting difficulties; Care for infants & children;

3. The risk of break in policy if premium is not paid Cover for specialist treatment;
in time;
In addition to treatment per se, the poor would need
4. Automatic cancellation would put both the benefits under other heads as well, such as:
parties into difficulty; Loss of daily wages;

5. In case of seasonal workers such payments Out of pocket expenses;
would not be possible;
Transportation costs;
f) These difficulties could be obviated, if the follow-
ing steps could be considered - Death/ disability due to hospital negligence;
1. Such insurance schemes should be community
oriented . Death/disability due to accident.

2. SHGs & NGOs could be involved in financing/ Given the poor premium paying ability of those in low
guaranteeing the premium payment. income groups it would be very hard to offer a cover
against all the above components desired above.
3. These and similar organisations could addition- Nevertheless,if strict cost controls could be imposed
ally take responsibility for collection and pay- with the willing participation of all those involved, many
ment to the insurer periodically. of the above covers could be considered which will in-
directly create the boom. The strategies for control-
4. The organisations financing, collecting, and ling the cost include-
guaranteeing could charge reasonable fees for Usage/ restriction to Government facilities only;
such services.
Treatment from named charitable hospital for
5. Since daily/ monthly savings target already in specific locality;
place such mechanisms could also work for col-
lecting the premium. Treatment at named hospital where low cost
treatment packages have been agreed upon;
2. Crafting the right product:
Customer aspirations towards healthcare services can Admission to general ward only;
be very demanding. This would include demand for pre-
ventive, curative and maintenance coverage, and over
time would be witnessing increased utilization as well
as expectations of higher order treatments. These
could put the viability of the micro-insurance schemes
in jeopardy over the longer term. If strict controls are
not imposed over costs and utilization rates, the pre-
mium will have to be raised steeply, making the cover
out of reach for those it is intended for:

You will never be happy if you continue to search for what happiness consists of. You will never live if you are looking for the meaning
of life.

14 February 2016 Life Insurance Today

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