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India's Health Insurance Industry

The health insurance industry, a branch of the general insurance has been existent for a long time.

It started in Europe as workers sickness benefits and evolved into the private sector covering the various sectors of the economy.

In India, the industry has had its own share of milestones and setbacks as you may discover in the discussion that follows.

Nature Of The Industry
The health insurance industry is mostly dominated by the private sector. The public sector acts as a regulatory body while providing the basic health care needed. The poor find it hard to access these services. Generally, the demand for proper healthcare far outweighs the supply for the same.

Problems in accessing the services coupled with the poor financial structure with little government support in the form of social security has been a big challenge in the industry. However, like any other service providers in these typical sectors, the principal of pooling is utilized.

Policies In The Market
This industry has policies that cater for the individual and family. The policies have been differentiated to penetrate in the various market niches. Typical policies include indemnity insurance (this is to compensate the client for the damage/loss incurred), cashless claim facilities (this, as the name suggests is to cater for the costs incurred without necessarily paying a cash lump sum to the insured.), and community based insurance.

Setbacks In The Industry
The main pitfalls that have been experienced in this industry have been the provider malpractice and the limited nature of the coverage provided. Medical institutions have been quoted to have taken advantage of the person’s cover and included exorbitant fees in the claim bills.

This is purely because a majority of persons have medical cover through employer schemes. Other malpractices include the failure of service providers to honor their promises and when they do, they delay the process making it hard for the claimant to recover from the loss. The other setback has been the inability to; for example, provide preventive healthcare policies like for vaccinations, voluntary testing etc. All these are exclusions on the policies.

The medical insurance industry has come in handy in times of various catastrophes like floods, earthquakes and accidents. These covers have gone a long way in assisting persons to recover from the loss and lead their individual lives as usual. However, a lot still needs to be done for this industry by its stakeholders.

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