Page 45 - Insurance Times September 2021

Y Controlling and monitoring of claims and creating
processing in Govt. and other group schemes.

The company may look for quota share support to shore up
the portfolio.

Group Health Policy underwriting
excluding Government :-
Group health policy catering to corporate is normally sourced
through brokers/agents apart from direct business procured
by office directly.

As the insurance coverage sought are dictated and designed
as per need and requirement of customer, rating would be
based upon sound actuarial principles, supportive data Y Incorporation of deductible/Co-pay
considering all the relevant aspects of pricing such as
Y Loading of premium where warranted
Y Morbidity experience by gender
Y Modification/deletion of covers granted
Y By age group
Y By occupation Tele-underwriting of Mediclaim Policy
Y By group size As discussed earlier, pre-policy medical check-up by the
Y Expenses insurance companies helped to reduce the risk of paying the
claim in near future.
Y Project margin
Although physical medical check-up help in knowing the
Discounts and loading as per objective criteria for the current health condition of a person but not a history of
renewals of GMP. particular ailment.
Y Claim experience in previous policy
Y Change in coverage So Tele-Underwriting is an option which is an efficient and cost
effective way to issue the policy to customers, who are digitally
Y Change in sum Insured
dependent and believe in on demand services with minimal
Y Limit of Indemnity sought customer barriers. Generally, people are friendlier over

Y Expected frequency/severity of losses telephonic conversation and rightly disclose their medical
conditions which can't be obtained through physical medical
Y Group size
check-up. It also reduces the turnaround time to issue a policy by
Y Age group insurer and also converting one more policy seeker to customer.
Y Medical inflation
Most of the private insurer in India/abroad are following this
Y Procurement cost
practice.
Y Management expenses

Y TPA service cost Medical Policy Underwriting During
Covid-19 Pandemic
Premium rates quoted keeping in view of above factors Claim
experience of GMP is monitored and analysed periodically. Covid Pandemic is a worldwide spread of corona virus,
suddenly disrupted business as human life remains under
Introduction of various loss measures are suggested to insured
where the claim experience is very adverse. It is a very threat. More than 27 Lacs people died in the whole world
important task for underwriter while underwriting such risk. due to this pandemic.
Y Application of suitable conditions and clauses
In this period, the insurers prefer Tele - Underwriting method
Y Restrictions in the limit because physical health check-up was restricted.

The Insurance Times, September 2021 45