Health Insurance, Cashless 'Juggernaut'!
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Case Code: INS054 Case Length: 10 Pages Period: 2010-2011 Pub Date: 2011 Teaching Note: Not Available |
Price: Rs.400 Organization: - Industry: - Countries: India Themes: Market Analysis |
Abstract Case Intro Excerpts
Introduction
Health insurance in India was promulgated initially by mandated social health insurance through different schemes of central and state governments. It was more a group policy and was not designed either for specific medical conditions or for any individual/family coverage. Penetration of health insurance picked up only after private insurance companies players introduced individual/family health insurance policies with flexibility and additional features. Cashless Claim facility was one of such product which nullified the need of 'initial spending and claiming later' aspect and had become instantly popular among customers.
Boosted by the popularity of cashless claim policies, health insurance grew at a brisk pace in India. Though the health insurance industry was growing, insurers complained that they were constrained by losses owing to factors like higher administration expenses, adverse claims ratio, high hospital charges and improper risk assessment.
To contain the losses, apart from other corrective measures, insurance companies proposed deduction and standardization of hospital charges.
When most of the hospitals refused the proposal, insurers went ahead and announced delisting the hospitals which rejected the proposal and scrapping cashless hospitalization facility.
This raised alarm in the customer groups and industry attracting the government, legal and regulating bodies to involve for an amicable solution...
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