Page 25 - The Insurance Times July 2020

retired employees of Public Sector Banks / Public Sector as the Group Aggregator (GA) is not evincing any interest
Units / Corporate Bodies / Corporations / Private Companies, to take up the matter with the concerned for resolution.
Self Employed & Professionals, Farmers & Artisans etc.,
whose annual income is below Rs.5 lakh and who are not This is compelling the policy holder either to continue with
members in any Government health insurance plans, need the same insurance company, though not interested, or join
to be covered under this scheme on priority. in another company and wait for 2 or 3 years for pre-existing
disease claims. The regulator has to look in to this area and
Further, there is an imminent need to support senior citizens ensure the portability to all policy holders who are
whose income is between Rs.5 to Rs.10 lakh per annum with interested.
cross subsidisation by the respective institutions in case of
retired employees and with regard to others, it should be It is observed that majority of GAs are not evincing the
done by the centre/states. desired attention to protect the interests of the group
members and not exercising their prudent negotiation skills
The cost of the health insurance policy mainly consists of with the Insurance companies while renewing the policies.
claims, operating expenses and taxes. On implementation They are more interested in fee income and dropping the
of GST regime, the tax component has increased from 15% policy holders like hot potato to the mercy of the insurance
to 18% which is a big burden on the policy holders. Health
companies.
care being a priority subject on the government agenda,
taxing the individuals that too on purchase of health
The argument of insurance players in favour of hike in
insurance policies is not fair. Government need to revisit its premium is mainly due to increased claims coupled with
stand and initiate steps to bring down GST to zero forthwith
medical inflation. The chief reason for this is not having
since the senior citizens need it the most.
uniform rate for each ailment or disease and the
treatment cost varies from hospital to hospital within a city/
Since health policies are subjected for renewal every year,
town. Further, it is a well known fact that private hospitals
it is the responsibility of the insurer to inform the changes
are charging extra to card holder compared to normal
in premium or any other terms & conditions of the policy,
cash payment. Thus, monetary cap on ailments and
to the insured well in advance. Conversely, the insurance
uniform billing with or without health card is the need of
companies are communicating the revised premium rates
the hour.
just before the due date of the policy, causing inconvenience
to the insured.
The Gen-S segment is known for their hard work, sacrifices,
devotion and dedication to the family, organisation where
Thus, the regulator has to ensure that the policy holder
they worked as well as to the society. It is not out of place
receive communication from the insured minimum three
to mention that the senior citizens are the most law-abiding
months before the due date to enable him/her to take
informed decision either to renew the policy or to switch to lot and have been genuinely paying taxes all through the
other insurance companies with seamless portability. years for the nation building. In the process they have
exhausted all their energies and resources and are left with
Levying premium based on the age of the policy holder is to little income to lead their second innings independently.
be scrapped forthwith especially in case of group policies.
The revision of the premium, if any, should be reasonable “Respect Elders”, though has a resonance in various forums,
and uniform across all age groups. but very little is done in letter and spirit. The Gen-S group is
forced to look up to the Government, Regulator and former
As per IRDAI guidelines, it is the responsibility of the employers not for any freebies or charity but for deserving
insurance companies to transfer the credit gained by the health coverage to continue their journey in their twilight
policy holder (individual or group) for pre existing conditions years with peace and dignity. The stakeholders need not be
and time bound exclusions, from one insurer to another reminded that this moral act is the least tribute that can
insurer within the time frame and without any rider. be paid to the elders who were once born young. Hope, good
Contrary, the group policy holder is deprived of portability days are ahead for Senior Citizens!!! T

The Insurance Times, July 2020 25