IRDAI has removed the ceiling age of 65 for health insurance, alongside reducing the cooling period of pre-existing diseases (PED) from 48 to 36 months + has reduced the moratorium from 90 to 60 months.
Freeway has been given in policy wording, structuring, innovating and developing new products to changing times.
These are definitely welcome measures.
But with a burgeoning geriatric population in India, the measures will still fall short to deliver affordable, customer friendly health insurance for the following reasons.
Despite removing the ceiling age, the regulator will need to ensure that products are designed to make senior citizen population adopt insurance as a natural choice.
For this pricing has to be controlled by either capping premium for a base bouquet of services, including out patient coverage, capping certain medical costs with decent hospitals on widespread basis besides including costs of reimbursing medicines as well.
Transparency
How insurers do this needs to be transparent and carefully monitored to ensure end-to-end principled delivery. Old age health cover should be a sectoral target for all insurers.
A product prototype from regulator or sand boxing will also enable/deepen health insurance.
For affordable citizens these offerings can come up with toppings, add on covers or with higher sub limits. Despite the reducing of PED tenure, still a senior citizen has to still wait for three-year cooling period to avail of insurance benefits.
This is too long a period given the fact we have the largest diabetic, BP and other old age ailing population. These people may be offered with a reduced waiting period or on co-payment basis. Group insurance is offered only if one is part of a natural coterie.- For senior citizens, this can be offered for specially “formed” groups through external aggregators. The list of measures/avenues are endless, both out of the box and some inside the box as well.
The challenge however is making/forcing it to happen. SEBI is in the process of sachetising SIP products to as low an amount of ₹250 per month to deepen market penetration. Something may need to be done on war footing on health insurance, else we will continue being a groaning and moaning population.
The writer is a chartered accountant