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Entering a New Era

Posted by - ICICI Lombard, GIC Ltd.
July 30 2018

"The health insurance sector has the agility to keep up with the changing risk scenario.”

Healthcare delivery is one of the key driving forces in the development process of a society, with health insurance being a critical building block. While the health insurance sector has been growing at a robust pace of more than 20 per cent CAGR over the last five years, its penetration remains relatively low at 32 per cent. Moreover, a large percentage of the insured are enrolled in government-sponsored health insurance schemes. While penetration should be bolstered by the implementation of the ensuing Ayushman Bharat (National Health Protection Scheme), retail health insurance penetration remains at just around 2 per cent.

The retail penetration challenge is being addressed through various initiatives that the health insurance industry is pursuing. Further, the insurance regulator has played a critical role in facilitating the same with interventions such as portability norms, long-term products, standardisation guidelines, protection of policyholders’ interests, lifelong renewability and so on. The recent introduction of pilot products and quick product approvals through use and-file guidelines have ensured that the health insurance sector has the agility to keep up with the changing risk scenario and customer preferences. One such case is the recent launch of cover for OPD or outpatient department-related expenses wherein the insured need not be hospitalised for more than 24 hours.

Even as efforts continue towards product development, insurers have been rightly shifting focus from being mere risk financiers to offering risk management solutions, driven by tech and uberisation. At ICICI Lombard, we have introduced solutions across customer health life cycle ranging from onsite health check-up to providing real-time risk scores, tracking customer health parameters through wearables, introducing AI-driven disease management chatbots, offering single-click access to primary care, emergency services and second opinions, and launching discovery platforms on the quality of care. As these interventions become mainstream, one can go beyond offering better solutions to incentivising customers in the form of premium reduction or additional benefits for positive health-related behaviour. Further, the next wave of technology solutions encouraging techonlogy in insurance industry, will enable deeper human interaction with data, making it possible to alert customers of upcoming risks. The transformation is not limited to data access and analytics. With InsureTech – Big Data, AI and robotic automation – solutions are being implemented across underwriting, claims and customer engagement.

While the industry undergoes a major overhaul in terms of product propositions, tech enablement and risk management practices, there remains a need for healthcare delivery collaboration among stakeholders to ensure better patient care and experience. It requires aggregation of patient information through blockchain, development of data standards, standard treatment guidelines, fraud reduction, speedier policy issuance and claim settlement. Initiatives such as Aadhar-linked digital locker and EHR standards are some steps taken by the government which are yet to be fully adopted by the ecosystem. The proposed Digital Information Security in Healthcare Act (DISHA) will ensure that checks are put in place to avoid misuse of data and enable complete visibility provided to the patient as owner.

The health insurance sector has come a long way since its inception. It needs to keep evolving rapidly to make sure that it continues to catalyse India’s inclusive growth.

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