Enhancing Consumer Experience in Health Insurance

Health Insurance

[This article was published in the October 2009 issue of the eHEALTH Magazine (]

3rd Health Insurance Summit organised by Confederation of Indian Industry on August 31, 2009 in New Delhi

3rd Health Insurance Summit organised by Confederation of Indian Industry on August 31, 2009 in New Delhi


Delivering the keynote address at the Summit, J Harinarayan, Chairman, IRDA, said Insurance companies need to work on database of hospitals and standardisation of hospitalisation processes and also towards integration of billing systems.

A large number of claims may be rejected due to genuine reasons but it still sends a very bad message to customers. There is need for having core coverages without too much of product complexity as it tends to confuse customers, said Mr. Harinarayan.

“Currently, health insurance is focused largely on hospitalisation whereas hospitalisation is only 1/3rd of overall healthcare costs. Insurers need to work on non-hospitalisation healthcare costs, while taking care of moral hazard issues,” added Mr Harinarayan.


Speaking on the occasion chief guest of the summit Mr. B.K. Chaturvedi, Member, Planning Commission said, ” Seventy per cent of expenditure on health is from the private pockets, with a majority from the rural areas. So, there is need to expand health care mechanisms to rural and semi-urban areas. We need to make investment in the two social sectors i.e. health and education, as being the focus of the Planning Commission’s 11th plan.”

Mr Chaturvedi called for a new approach to consumer awareness. He assured that policy implications of recommendations made at the CII Summit would be considered by the Planning Commission. He also pointed out that the current products focus is on inpatient expenses, whereas the bulk of expenditure is outside the hospital. Thus products should cover this as well.

Mr. Malvinder Mohan Singh, Group Chairman, Fortis Healthcare and Religare Enterprise and Chairman CII National Task Force on Health Insurance said, “Healthcare has to make transition from curative to preventive care over the next few years and providers need to have minimum accreditation for ensuring minimum standards of care. Today this is largely missing. There is great need for investments in delivery network. Current network is not adequate and insurers need to see that there are right checks and balances for payments.”

Ms. Shobana Kamineni, utive Director, Apollo Hospitals Group and whole time Director, Apollo DKV Health Insurance said, “there should be focus on enhancing consumer experience in health insurance. This has to be kept in mind by the standalone health insurers, who are in a better position to do so.

Focus areas for product innovation would be core health products, health & wealth products, lifestyle products.

She called for an innovative approach to consumer education as adopted by bodies like the National Egg Coordination Committee and NDDB. The key to success would be to keep in mind consumer focus, be involved for the long term, ensure sustainability and consumer focus which delivering innovative products.

Mr. V Vaidyanathan, CEO & MD, ICICI Prudential, in his address mentioned that a range of initiatives like tax incentives etc. could be introduced to increase growth and penetration of health insurance. Current health insurance model is heavily push oriented, that needs to be changed.

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