Page 171 - India Insurance Report 2023- BIMTECH

India Insurance Report - Series II 159

of technology for all these aspects indicate the progressive evolution of the government-sponsored health
insurance schemes. The Scheme has opened 1,50,000 health and wellness centres as of December 2022 to
deliver comprehensive Primary Health Care. The secondary and tertiary care requiring hospitalization is
covered under PMJAY. The premium is subsidized by Central and State governments. The state decides
the scheme’s modus operandi: whether to rope in Insurance Companies for implementation, manage on
their own by a Trust Model, or have a combination of insurance and the trust mode.

5. Group Corporate Health Insurance

There was a surge of group medical insurance by the corporates initially, and for a long time, who
gauged the thirst of insurers for premium at any cost! Exotically designed but not commercially viable
policies were offered to lure the corporates into giving their profitable property business.

The next group insurance scheme which insurers initiated was with the aid of Bancassurance. All
bancassurance tie-ups had a Group Health Insurance scheme offering Health Insurance to their banking
customers and dependents. Banks earned substantial “risk-free” fee-based income for every policy they
sold to their customers.

Similarly, any entity having a large number of members, be it a club, a professional organization, or even
an entity having access to a large number of people to offer health insurance ostensibly as a means of protection
but covertly to further the goals of their organization, grew horizontally by attracting more members through
a tempting health insurance plan, which was low cost, offered a coverage wider in scope than the individual
policies available in the market. Thus, the common man could now choose to insure through his or her
employer, bank, or an organization where he/she was a member or could become a member.

All the variants of the group insurance schemes accomplished several positives for the health insurance
segment. The number of people covered in 2013 -14 was 21 crores as against approx. Fifty-two crores
were covered in the years 21-22, of which around 59 per cent of the lives were covered under government-
sponsored health insurance schemes. Thirty-one per cent in group business, and only about 10 per cent
under individual policies issued by general and health insurers.

The hospitals, too, responded to such schemes, whether corporate group or State group, by offering
cashless, and the insured policyholders could actually “experience” the benefit of health protection. This
resulted in many of them continuing the cover after the group insurance stopped and nudging their
family and friends to go in for this insurance. The States which have been continuously implementing
these schemes saw improved infrastructure in the Government hospitals.

The regulatory framework facilitated the designing of ‘customized’ or ‘tailormade’ insurance covers
for group health policies, unleashing the imagination of the insurers and group organizers to give maximum
coverage to their beneficiaries. In the case of corporates, the employers wanted their employees to have
a “wow” experience when undergoing treatment themselves or supporting their loved ones; they believed
such a policy could positively affect the employees!
Anecdotal substantiation shows that attractive medical insurance rather than a higher pay scale has
become a major factor for the younger generation to shift jobs since their parents /in-laws are also