In its compelling case for universal health coverage, the World Bank says it "allows countries to make the most of their most powerful asset: human capital." This idea is very relevant to India, which will have the largest number of workforce in the world by 2027. To harness our demographic dividend in the service of economic growth, we need to be able to make the most of it. a healthy workforce. It follows that all Indians must have access to the health services they need, without affecting their productivity or crippling financial burden.
To this end, 2018 has been a pivotal year for health Insurance in India. Ayushman Bharat, the world's largest audience health Insurance scheme, will benefit 500 million unprecedented Indians. With prospective regulation, the Insurance The Regulatory and Development Authority of India (IRDAI) has paved the way for greater inclusion, placing HIV and mental health insurance. Starting in 2019, these and other emerging trends will unlock value for millions of customers, while increasing the penetration of health insurance in the country. A look at the changes I see emerging in 2019.
Growing inclusion with customer-centric regulation
Clients have often complained of the complex terminology of health insurance policies. That should change in 2019. An IRDAI working group made some important recommendations on standardizing exclusions in health insurance. One proposed change is to limit the number of diseases and illnesses remaining outside the scope of insurance coverage. Another key recommendation is that after 8 years, insurers will not be able to deny a non-disclosure claim at the time of policy underwriting, thus protecting the interests of clients. The standardization of exclusions would benefit customers on many levels. It would regulate insurance contracts by standardizing the wording of contracts, thereby minimizing differences between products and insurers. This would lead to more complete products. Most importantly, it would improve the customer experience, with rules that are clear and simple to understand.
Until 2018, IRDAI stepped up its efforts to strengthen inclusion and make health insurance more comprehensive. The impact will follow in 2019, as insurers solve the implementation problems. For example, although data on HIV mortality rates in India are available, they are insufficient in terms of morbidity, making it difficult to set premiums. While insurers could initially introduce additional coverage for HIV and mental illnesses, stand-alone products will appear with experience over a longer period.
Towards a technology-driven value proposition
Wearable tech and the Internet of Things (IoT) are on the verge of reversing health insurance in India. Portable devices can capture data that provides actionable information – from heart rate monitoring to monitoring blood pressure and sugar levels. As part of the data privacy guidelines, insurers could use information to develop customized products for the customer. This could be based on age, geography, current health status, family history, and exercise program, among other factors. Insurers will know the risks associated with a client's lifestyle, so they can design the most appropriate coverage for their needs at an appropriate price. In addition to being integrated with the product, portable equipment and IoT will also have applications at the integration stage. Monitoring the client's blood sugar while underwriting the risk could guide an insurer in offering a personalized diabetes product at a fair price for that client. I also see wearable devices that are accelerating the shift from responsive care to preventative care, as clients proactively seek to prevent chronic disease.
Insurers will increasingly use technology in the near future to create products of a specific nature. This could be at the level of the disease, that is, products intended for cancer, heart disease, diabetics or adapted to particular customer segments, such as products that reward customers for a healthier life. IRDAI recently announced its "sandbox regulatory approach" for financial technology innovations, aimed at improving efficiency, managing risk and increasing value. added for customers. This will further encourage breakthrough ideas within the industry.
Provide value and convenience with a tailored service
As client expectations evolve, the scope of covered expenses – from outpatient consultations to diagnoses, through pharmacies and preventive health care – will extend well beyond hospitalization. When we created GoActive, which focuses on health and fitness every day, our research revealed that customers wanted everyday convenience. They asked for overall expenses for Health care – 65% of expenses are usually borne by the insurer. As a result, insurers are developing new models and ecosystems, based on technology and data analysis, to cover a wider range of expenses offering this convenience.
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Clients want insurers to simplify Health care trip for them, and this will guide the direction of the products in 2019. The growing race of technology-savvy Indians is giving a premium to their time and wants regular health activities such as scheduling doctor's appointments or Personalized support for health is available at all times. ! In a survey we conducted in six cities, more than a third of potential buyers said they were willing to download a health insurance application. Based on customer information, our health app integrates real-time appointments with physicians, cashless payments and online medication orders, all in one place, accessible at all times and in one go. click.
The health insurance sector grew by 40% this year. This growth was largely driven by the launch of Ayushman Bharat, which largely contributed to the growing awareness of health insurance. An inclusive regulation will standardize the rules of the game and allow many more Indians to have access to health insurance. Insurers now have new opportunities to expand their services by offering customers incredible value, convenience and differentiated services, integrated into a personalized experience. In this new landscape, I see the role of the insurer turning from facilitator and provider into partner for a new generation of clients.
The author is MD & CEO, Max Bupa Health Insurance