Page 46 - Insurance Times September 2021

Appointed doctors over telephone ask customers regarding Y Standard exclusion wordings as per IRDA
basic health condition, lifestyle of customer etc. After
Y Removal of exclusions for HIV/AIDS, Genetic disorders,
satisfaction, policy was issued to customer by Insurance Psychiatric and psychosomatic disorders
Company.
Y Ayurvedic/Homeopathic/Unani treatment
In a nut-shell, we can say that health insurance underwriting
Y Mental Illness cover
is a purely technical step whether someone should be taken
as a customer at affordable cost (premium), so that goal of Y Coverage for Robotic surgeries, oral chemotherapy,
profit with growth can be achieved by insurance companies. Deep brain stimulation, Stem cell therapy,
Immunotherapy etc.
Now due to advances in technology, operations, awareness
for health insurance, medical cost inflation, customer's mind Accordingly, product may be designed, and cost may be fixed,
set to avail best choice of hospitals for treatment, we have to however an accurate understanding of customer's health is
look at underwriting in a changed prospect: - required.
1. Develop financially attractive products, customer centric
process and technical soundness. Correct assessment of risk for accurate price.
2. More focus on health care management, so free health
checks ups to policy holders or free health check-up camp. It is important to check fraud at this stage because many
So that health may be improved, and it will help in customers try to hide some important information. So,
lowering of medical cost. customer attitude is an important factor while understanding
risk.
3. Increase transparency, simpler medical questionnaires,
use of digital channel is the need of hour in changing
scenario. Simplified medical questionnaire can improve the customer
experience and data accuracy.
4. To achieve the prudent underwriting goal, insurance
companies must focus on For groups, tailor-made policies can be designed and price
Y Technical soundness
may be fixed. For large groups, cross subsidization with other
Y Innovation of products as per need and requirement portfolio is also one option for insurer as a part of underwriting
of customers' means focused product innovation.
strategy.
Y Customer centric approach.
A particular customer segment may be targeted for product
In health insurance underwriting or even other insurance, design and costing.
risk assessment, evaluation, cost, coverage, limited liability,
exclusions, co-pay condition etc. is to be understood. So, underwriter should be able to manage
Y High cost claims
How to deal with rare diseases with higher cost of treatment.
So at the inception of policy, identification of such diseases is Y Prevent uncontrolled renewals
must so that cost (premium) may be decided accordingly.
Y Risk premium is based on scientific evidence.
Product innovation is also one area where different products
for senior citizens, critical illness cover products with add on Y Skill and motivation of the underwriting staff.
cover like Y Different departments like Product development,
Y Air ambulance charges Underwriting, claim management, Health management
Y Organ donor benefit should work much closely together.
Y Modern treatment methods with advanced technologies
At last but not the least, a high degree of professionalism is
for certain diseases
the need of hour for underwriting of health insurance to
Y Restoration of Sum Insured achieve the Moto
Y Daily cash allowance
Y Second medical opinion "Growth with Profit".

46 The Insurance Times, September 2021