Page 14 - Insurance Times April 2024

rejecting the insurance claim in 2018 LIC said, "The ground taken is that the ately on 29.03.2016 or even prior to
when it should have honoured it. fact that the insured was undergoing making the consideration payment for
"The Policy was a health premium policy treatment at NRI Hospital for sus- completion of the policy, we would
securing the insured for a sum of Rupees pected cancer and had not been dis- have referred the matter to our Cor-
one crore on payment of Rs 7,00,000/- closed in terms of the declaration porate Office and appropriate decision
and odd as premium. The usual medi- which is required to be given during would have been taken."
cal and eco tests before accepting the the interregnum of the pendency of The husband of the deceased was dis-
said policy were carried out and the the proposal. In the absence of any appointed with this rejection by the
policy was approved on 29th March information about ill-health of the Life insurer in 2018 and filed an appeal
2016. Premium was paid and a receipt Assured, the policy was completed against LIC in NCDRC.
for the same was issued on 30th March with utmost good faith on 30.03.2016.
2016," said LIC before NCDRC. Had the ill-health of the Life proposed ESIC approves Rs. 1,128
been brought to our notice immedi-
crore for construction of 7
Tax benefits not prime motivator to buy health in- hospitals

surance, finds ICICI Lombard survey Employees' State Insurance Corpora-
tion (ESIC) has approved Rs 1,128.21
Majority of health insurance buyers do not consider tax deductions on health
crore for construction of seven ESI
insurance premiums under section 80D as the chief motivation for buying
Hospitals in Karnataka, UP, Madhya
these covers, an ICICI Lombard General Insurance survey has found.
Pradesh and Odisha.
The study polled 762 Tier-1 and metro city-dwellers in the age group of 21-
The decision was taken at a meeting
55 years who have made at least one tax-saving financial investment, own
a health insurance policy or have an intention to purchase one. of Standing Committee of ESIC under
the chairpersonship of Union Labour
The report on tax savings and health insurance says that only 30 percent of Secretary Sumita Dawra, a labour
health insurance buyers cited tax exemptions as the key reason for buying ministry statement said.
health insurance. "Cashless claim emerges as the top reason for the inten-
The seven ESI Hospitals will be con-
tion to purchase health insurance, followed by the protection of savings and
structed at Harohalli, Narsapura,
managing inflating medical costs. Intentions for health insurance purchase Bommasandra (Karnataka), Meerut,
are not solely driven by tax benefits," the study said.
Bareilly (Uttar Pradesh), Pithampur
Close to 63 percent of the respondents identified Rs 8,000-30,000 as the (Madhya Pradesh) and Duburi
optimal annual premium bank for an individual health insurance policy. How- (Odisha).
ever, those in the age group of 36-55 years are willing to spend a bit more
on premiums. For more than half of such respondents, the lower end of the Star Health surpasses one
range was higher at Rs 10,000.
crore claim settlements
On the tax-saving front, over one-third (36 percent) of those polled were The average length of stay of patients
not aware of tax benefits associated with health insurance. in hospitals has decreased since 2008
Those under the age of 60 can claim tax deductions of up to Rs 25,000 on but the average size of medical insur-
health insurance premiums paid towards self, spouse and kids. In addition, ance claims has increased four times,
individuals can also avail of deductions on premiums paid towards parents' according to Star Health and Allied
health policies. Senior citizen (or their children who pay their premiums) Insurance Company Ltd.
are eligible for tax deductions of up to Rs 50,000 on health insurance pre- Since 2008, patients have experienced
miums. a 20 per cent decrease in the average
More than 60 percent of those polled relied on friends, family and their bank length of stay in hospitals due to rapid
relationship managers as key sources of information on making tax-saver medical developments. On the other
investments. However, those in the younger age bands (21-35 years) were hand, the average claim size has in-
more inclined to rely on research and information available in the public creased fourfold, indicating medical
domain, the survey found. Close to 98 percent of respondents who already inflation and the rising expense of so-
have health insurance covers in place said they were likely to renew their phisticated equipment and treatment.
policies next year. During its Q3FY24 earnings call, the

14 April 2024 The Insurance Times