Thaindian News

Kolkata, Aug 21 (IANS) The public sector health insurance companies are planning to design health insurance according to the paying ability of the consumers, a top National Insurance Company (NIC) official said here Saturday.
“It is evolving towards designing policies based on the paying ability of the consumers,” A.V. Girija Kumar, director, NIC, told reporters on the sidelines of a seminar organised by the Indian Chamber of Commerce.

He said: “Billing is much higher for those availing cashless facility than those who don’t.” This has led to a situation for large claims ratio for the insurance companies, which was becoming unaffordable for the companies.

“It is not that cashless facility has been withdrawn, it is only some kind of restructuring that is taking place keeping in mind the larger interest of the consumers,” Kumar said.

He said the main aim of the public sector insurers is to reduce cost of insurance and to see that the benefit of the insurance package is not exhausted in one go for one ailment for the consumer because of over billing by some hospitals.

“At the end of the day the intention is keeping the interest of the policy holder in mind. Neither we, nor hospitals should deny them service. We should work together to rationalise the costs.”

The public sector insurance companies are also looking at setting up ailment-wise health insurance packages.

“We are looking if ailment-wise limits could be taken up, and if possible separate products can be designed over a period of time. If somebody prefers expensive hospitals, he would necessarily have to bear higher costs (of policy),” Kumar said.

He confirmed that there would be no withdrawal of benefit for the consumers.

In National Insurance Company, health insurance claims last year were 108 percent - including individual and group mediclaim.