Expert View

Health Insurance

Q.1. Can you share your insights on the penetration of health insurance in India as compared to the global market?

Penetration of health insurance in India is a dual issue, in the sense that insurance sector is responsible for the distribution and also is a function of how healthcare, private healthcare, takes off. Most of the spends happen there and you need insurance to be able to access private healthcare. About 20 years ago, there was hardly any private healthcare other than smaller unorganized infrastructure. Today organized private healthcare has grown multifold where you need insurance to be able to access it. So that has started growing in India. Similarly, the insurance sector was also liberalized about 15-17 years ago, therefore focus on health insurance has come in a big way. A push towards retail health insurance was a whole attempt to build the penetration in India. At the start of liberalization it was 0.5% of GDP, now currently it is at 0.8% even now it is low, in the non-life sector, compared to the developed countries where it is minimum 2-3%. This is where the healthcare penetration is at this point in time. It is around 28% of the market. It has grown in 3 segments, which are retail healthcare, corporate healthcare and mass healthcare which is basically government initiatives.

There has also been an attempt through bankassurance to be able to build health products, which are non-reimbursement types which are commonly known as the health benefit products segment. This has happened as attachment products which are loan based products such as mortgages insurances. This has also helped penetrate the market and also build a retail distribution with the customers.

Q.2. Considering the growing trend of health insurance in India, and as the awareness increases what are the strategic plans by ICICI Lombard to increase the penetration in the Indian strata?

We always remain bullish on the health insurance; we believe that it is one segment which will continue to grow in India. It is a social initiative which we need to contribute towards. We believe that every citizen should have a basic form of coverage, be it from the employer or on its own and for that purpose, we have worked to increase the reach and the penetration in not only the retail segment, but we have also contributed toward employer-employee segment. We are also pioneers in working with the government-sponsored health insurance covers. As and when that sector opens up and the government decides to increase the purchase of health insurance, we hope to be a part of those initiatives.

Q.3. With innovations in different types of products and services by ICICI Lombard such as government insurance covers, what other things make ICICI different as compared to its competitors?

We believe that key method, towards penetrating health insurance, is through the service route. We build trust on the product itself; whatever may be the form of the product, the big thing is to be able to access the product when you have a catastrophic event in your life. Providing the money to treat critical illnesses or access to cashless facilities in remote locations, such initiatives become very important for us from service architecture point of view. It helps to give trust to the customer that having a health insurance cover is a prerequisite for risk management of personal life.

Having said that, what we achieved was, we were the first company to set up in-house claim settlement service architecture where we had recruited own doctors, we connected to the hospital chains where we set up cashless facilities. Around 3000 hospitals in the urban network is what we created, apart from that we also created a rural network as well. We set up a central processing unit which is very much technology-driven and got people with right trading attitude and background to able to interface with customers about their healthcare access needs. The customers can get advice, can have access to any kind of healthcare be it on the OPD side, or patient side, etc. and in the entire process, they will be getting updates and hence have trust in the process. So they are aware of what they have paid for and what they need to wear themselves. We wanted to develop this entire chain. Secondly, what we try to do is to give value back to the customer, basis our interaction with the network. The confidence that we have reduces leakages, frauds and increases quality treatment for our customers.

What we attempt to do on the product side is build health benefit product like critical illness products, give payouts on particular critical illness happening, etc. So that's something that helps the customers not only to get the payment but also access money to take care of the surrounding needs of the healthcare event. The surrounding needs, apart from surgery or treatment, are associated costs involved in healthcare events; all this is possible through a health benefit product. We also work to increase the richness of the product construct on the health indemnity side. We have also tried many innovations in our product through initiatives like having outpatient coverage, develop cashless access to outpatient, etc.

Q.4. How is Tele Consulting viewed by ICICI Lombard? What's the future of teleconsultation in this business considering Artificial Intelligence (AI) coming in the picture?

Healthcare has evolved, and there is a lot of use of technology like teleconsulting. The primary use of teleconsultation is to bridge the locational gap to access specialized care. Someone from the rural area can access specialized health care from an urban area. Health parameters, test results are easily transportable with technology so that people can view it remotely and be able to make a correct diagnosis. This has ensured good access to quality healthcare services. But this does not preclude the whole idea of having a quality healthcare; there is proper diagnosis and then comes the healthcare. You need to have a proper treatment after diagnosis. Teleconsultation is just a means to the right end - access to right healthcare - for this you need access to quality healthcare and also finance through good insurance products.

Q.5. In today's world, people migrate to new cities, countries for work and career. What does ICICI Lombard offer in terms of Health Insurance policies for such people?

For people who migrate overseas, we are able to build solutions which not only cover them for domestic healthcare access needs but also enable them to access healthcare, if and when they need it, at remote locations when they are out of the country. Their ability to access that healthcare establishment is dependent on coverage of their employers. For that we are tying-up with employers, giving them solutions where people can be empowered to be able to access healthcare in remote locations, anywhere in the world. We are gearing up to provide those kinds of facilities to them. Also, we aim to help them manage their healthcare outside, for example, people tend to come back home in case of medical emergencies faced abroad to get expected and normal health service at home. That's why we built service architecture with sensitivity to handle them in such scenarios through the coverage that their company provides.

Q.6. There is another B2B2C platform where employees of your clients get special insurance packages; can you tell us more about that?

What we encourage is for the employees in a particular corporate to be able to access to healthcare needs over and above what they employer provides by giving them a cover option directly from us. The transaction of the contract is between us and the employee concerned, but the entire facilitation of that transaction is through the HR of the company itself. For this, we develop customized covers specific to the employee needs. If they want to have access to our retail products, for that we develop facilitation access where they can use company infrastructure or company distribution architecture to reach out to us. They can use company intranet which would make it easy for employees to buy and get servicing for their healthcare needs at their convenience and at their workstation. Entire service would be provided at once, so they also have trust and confidence in our system.

Q.7. Considering how important the health insurance is for everyone, what is ICICI Lombard doing for enhancing health and wellness apart from providing health insurance to the people?

One of the key philosophical thoughts we have in health risk management is that every person should be empowered to be able to manage his own health risk by avoiding obvious health emergencies. He or she needs to take small steps to ward off infectious diseases. It depends on how does one takes care of basic health parameters like diet, weight, etc. and manage other chronic conditions such as BP, sugar levels, etc. This we believe goes a long way towards having a person who is motivated to keep himself healthy and only looks at access to healthcare as a rare exception. We are there when he/she needs help, but we believe he or she should be kept out of the hospital. We believe going to the hospital is the last need; a person should keep himself or herself healthy, watch health parameters, and work on the wellness. Our endeavor as a company is to help people to do all of that, so that they rarely access healthcare. For this, we built an entire wellness awareness campaign; we are trying to do many awareness programs.

'Do the Difficult' campaign by ICICI Lombard was one such campaign aimed at increasing health and wellness awareness of our customers. The central theme of the nation-wide campaign aimed to nudge people towards keeping commitments once made – staying active and maintaining a healthy lifestyle being the important components of this. The campaign helped empower customers to stay healthy and happy. It involved a TVC which was run on over 70 TV channels, and major radio stations and was also supported by a 360 degree marketing campaign involving print, outdoor, radio and digital communication along with internal branding activities to drive the message to the target audience. Special hashtag #DoTheDifficult was also created to promote the campaign.

Our support is not only around insurance and claim settlement, that is basic we promise to every customer. On top of that, we are trying to help customers to believe that they can be fit, do the difficult and take necessary steps with our help. For retail as well as corporate side, we conduct many wellness programs on very simple but important things like smoking cessation, maternity programs, etc. This helps employees to be fit and concentrate on work and productivity. We also have set up health advisor unit which customers can reach out to. They can also refer to our website for various health initiatives on which they can be better informed and advised.

Q.8. What is the success mantra behind successful claim settlement target?

It is one simple thing; we believe that customers have a basic right to access quality healthcare. They have a right to information about keeping fit and healthy, for which we are building a lot of awareness initiatives. Finally, the customer has the right to be able to buy quality health insurance products which actually fit his needs, access the right healthcare of his choice in emergencies.