Page 11 - Insurance Times December 2021

Health Insurance

News

Govt must expand health expenditure on health has constrained erage ticket size of these claims over
the capacity and quality of healthcare two years, from 2019-20 to now, which
cover to the missing services in the public sector. It diverts is about 10 per cent compounded
middle: Niti Aayog the majority of individuals-about two- growth.
thirds-to seek treatment in the costlier
The government can expand private sector. However, low financial "As Covid claims have come down, the
Ayushman Bharat Pradhan Mantri Jan frequency of non-Covid health claims
protection leads to high out-of-pocket
Arogya Yojana (AB-PMJAY) coverage to has gone up. Some of the other infec-
expenditure (OOPE). India's population
the poorest segments of the missing tious diseases have spiked this year
is vulnerable to catastrophic spending,
middle population, and leverage the such as malaria, chikungunya and den-
and impoverishment from expensive
scheme's infrastructure to offer a vol- trips to hospitals and other health fa- gue. Also, there was some amount of
untary contributory enrolment, NITI cilities. At least 30% of the population, backlog of the elective surgeries that
Aayog, government's policy think tank or 400 million individuals-called the have now caught up in this quarter,"
has recommended in a report re- missing middle in this report-are devoid he said in an interview, adding that the
leased. of any financial protection for health, ticket size of claims has gone up for
similar ailments.
The report titled "Health Insurance for the report said.
"We'll have to see if it's a temporary
India's Missing Middle", brought out
the gaps in the health insurance cov- Surge in non-Covid health increase or permanent in nature. This
could perhaps be because of additional
erage across the Indian population and cover claims RT-PCR tests that hospitals have do or
offers solutions to address the situa-
In a breather to non-life insurance some more procedures that they're
tion. The report highlights the need
companies, Covid-related health insur- following, but hopefully that will
for designing a low-cost comprehensive ance claims have dropped with the stabilise," he said, adding that if
health insurance product for the miss- ebbing of the second wave of the pan- healthcare costs continue to increase
ing middle. It primarily recognizes the demic. at the level they are going up it could
policy issue of low financial protection
However, there has been a rise in non- start impacting the premium for cus-
for health for the missing middle seg- tomers.
Covid-related health claims and their
ment and highlights health insurance average ticket size has risen signifi-
as a potential pathway in addressing Dasgupta said that the insurer in-
cantly, said Bhargav Dasgupta, Manag- creased pricing on its corporate health
that. In doing so, the report offers a ing Director and CEO, ICICI Lombard portfolio, but is on the wait-and-watch
starting point for broader discussions General Insurance. If this trend contin- mode on retail health insurance.
on solutions, and specific products, to ues, it could impact health insurance
improve insurance coverage for the premium. Between April and September 2021,
missing middle. the insurer received 72,059 Covid-re-
According to Dasgupta, the insurer has lated health claims and 2,38,409
The report noted that low government seen a 20 per cent increase in the av- claims for non-Covid cases.

The Insurance Times, December 2021 11