Page 14 - The Insurance Times April 2025

revealed that less than one per cent of Prudential & HCL Group form JV for health insurance
corporate health insurance claims are
related to mental health. The UK-based Prudential announced the establishment of a standalone
health insurance company in partnership with Vama Sundari Investments
It is in sharp contrast to the last Na-
(Delhi), a firm owned by the HCL Group promoter.
tional Mental Health Survey (NMHS)
2015-16, which had revealed that 10.6 Subject to regulatory approvals, Prudential Group Holdings — a UK subsid-
per cent adults in India suffered from iary of Prudential plc — will hold 70% stake in the joint venture and Vama
mental disorders. The government re- Sundari Investments the remaining 30%, according to a company statement.
cently launched the second phase of Anil Wadhwani, chief executive officer of Prudential plc, said India is a key
NMHS, which will come out with post strategic market for the company. “we have a significant presence in India
pandemic scenario. The Economic Sur- with life insurance and asset management businesses, offering a compre-
vey 2023-24 too had, for the first time, hensive suite of insurance and wealth products,” he said.
raised this critical issue while referring The health insurance joint venture will be led by Amar Joshi, CEO-designate.
to NMHS.
Joshi has previously worked with ICICI Prudential Life Insurance, Birla Sun
"India's health insurance frameworks Life Insurance, and SBI General Insurance.
must evolve to provide comprehensive, Under current foreign direct investment (FDI) rules, foreign insurers can hold
compassionate coverage for mental up to 74% stake in Indian health insurance companies. The government is
health. By doing so, they would ensure currently in the process of allowing 100% FDI in the insurance sector.
that individuals with mental health
conditions receive the care, dignity, Prudential plc already has a long-standing joint venture with ICICI Bank, op-
and timely support they rightfully de- erating through ICICI Prudential Life Insurance Company. This JV is India’s
third-largest private life insurer by premium, behind SBI Life Insurance and
serve," said Neerja Birla, Founder &
Chairperson, Aditya Birla Education HDFC Life Insurance.
Trust. The insurance market in India offers growth opportunities for its players,
Beyond awareness and stigma, struc- especially in health, savings, protection and retirement sectors.
tural problems within the insurance
market also contribute to the low the official investigations are yet to ducts regular audits and thematic in-
utilisation of mental health benefits. conclude, the regulator is likely to take spections as part of its regulatory over-
The health insurance coverage in India action against the insurer. Apart from sight in line with the framework out-
is largely for inpatients, but a big part Star Health, IRDAI has also scrutinised lined in its master circulars. These as-
of the mental health services is for the 8-10 other general and health insurers sessments are a routine process to
outpatient including consultations, in the country. However, no word of ensure compliance across the industry.
therapy, and assessments, which are any action being taken against them The media statement appeared to be
often excluded from coverage. has been reported. speculative and motivated in nature,
"The exclusions within policies pose a According to the report, IRDAI exam- and we have not received any commu-
significant challenge. They further di- ined various claim-related aspects, nication on this subject from the regu-
minish the already limited scope of such as the number of claims repudi- lator.”
mental health coverage," said Sanjay ated and accepted, deductions, queries As per IRDAI’s handbook of insurance
Kedia, CEO, Marsh McLennan India. raised by policyholders, etc. statistics, Star Health’s incurred claim
As per an official statement by Star ratio, i.e., the quantum of premiums
Star Health on IRDAI radar Health, they have not received any any insurance company pays out as
communication from IRDAI on this claims with the total premiums it has
for health insurance claim matter. collected in a year, for the year 2023-
settlement practices “We wish to reassure all our stakehold- 2024, stood at 66.47%.

Insurance watchdog IRDAI has discov- ers that at Star Health Insurance, we In essence, this means that for every
ered serious lapses in the claim settle- are committed to a customer-centric Rs 100 that Star Health collected as
ment practices of stand-alone health approach, ensuring that our processes premiums, it only pays approximately
insurer Star Health and Allied Insur- and practices align with the best inter- Rs 67 towards honoring policyholder
ance, according to CNBC-TV18. While ests of our policyholders. IRDAI con- claims between 2023-2024.

14 April 2025 The Insurance Times