ACCENT JOURNAL OF ECONOMICS ECOLOGY & ENGINEERING Peer Reviewed and Refereed Journal, ISSN NO. 2456-1037
Available Online: www.ajeee.co.in/index.php/AJEEE
Vol. 06, Issue 01,January 2021 IMPACT FACTOR: 7.98 (INTERNATIONAL JOURNAL) 101 CHALLENGES AND PRIORITIES OF INDIAN HEALTH INSURANCE INDUSTRY
Dr. Priya Jain
Asst. Professor, P. M. B. Gujarati Commerce College, Indore Insurance is backbone of country’s risk
management system and health insurance is an important part of this system as it provides protection against risk to that asset which is the asset of utmost importance for a nation that are it’s “Human Beings”. Life style disease.
Tax planning. And increasing level of education improved understanding of people towards need of health insurance.
So, this phenomenon creates superb opportunities to existing insurance player in Indian Market and attracts new players also.
During the FY 2018-19,1 General
& Health Insurance Companies collected 44873 crores as Health Insurance Premium registering a growth of 21.2%
over the previous FY 2017-18. Health insurance premium continues to grow over 20% year on year during the past four financial years. The growth rate is doing good and attractive. But every line of business has to face several challenges and at the same time may have different opportunities. Health Insurance sector is not an exception.
1 SWOT ANALYSIS OF INDIAN HEALTH INSURANCE INDUSTRY:
STRENGTH
Growing GDP results in increasing disposable income and hence investment in health insurance also.
Government is proposing to increase FDI to 74%2 from 49% at present, building more trust among foreign counterparts in Indian health insurance industry.
Private hospitals are moving towards tire II tire III cities.
Health insurance industry has potential to be a largest industry. It is fastest growing sector (over 20
% 3 per annum) than other segments of GI.
1 IRDA Annual Report 2018-19
2https://www.thehindubusinessline.com/economy/
policy/bill-to-raise-fdi-in-insurance-sector-to- 74/article34076720.ece
3 IRDA Annual Report 2018 -19 (IRDA Annual Report , 2018 - 19)
Since the health care and health insurance industry is still untapped, there is plenty opportunities of employment.
Private players are making the market more competitive hence customer became king.
2 WEAKNESS:
Poor infrastructure and limited access to healthcare especially in rural and semi urban areas.
Lower public spending on health care.
Lack of a proper and systematic framework to regulate and manage health insurance industry.
Lack of standards regarding process, definition, treatment cost etc.
Lack of properly managed data on disease pattern and consumer results in under pricing and higher claim amounts.
Huge underwriting losses in health insurance business.
Cashless facility is not available in each hospital.
To take treatment in non-network hospital made health insurance less attractive as here customer have to pay medical bill than after it reimbursed by insurer to him.
People don’t feel easy with paper work at the time of taking policy and at the time of claim.
Generally, there are negative tendency of people with respect to Claim Procedure, Preauthorization from TPA, and claim reimbursement.
3 OPPORTUNITIES:
There is great potential for insurers as market is still untapped.
Public and private insurance companies are innovating low cost, low-asset base models that make possible availability of Healthcare at lower prices.
Light regulatory framework.
ACCENT JOURNAL OF ECONOMICS ECOLOGY & ENGINEERING Peer Reviewed and Refereed Journal, ISSN NO. 2456-1037
Available Online: www.ajeee.co.in/index.php/AJEEE
Vol. 06, Issue 01,January 2021 IMPACT FACTOR: 7.98 (INTERNATIONAL JOURNAL) 102
Surging medical costs and increasing cases of non- communicable and life-style disease, treatment of that is expensive.
Health insurance premium accounts for only 24%4of total GI Premium in India, so there is a great opportunity to work.
Demand for HI is going to high due to current lack of supply.
Continuous increase in average income level and population of middle income group.
4 THREATS:
Customers always feel fear to deal with private insurer and have doubt on them.
There are so many deductions and exclusions make the policies less attractive.
Companies are solving queries through online services or call centre but the people sitting there to answer don’t have expert knowledge and give reply based upon scripts.
Increasing cost of treatment may make the current medical policy void or insufficient and customer feels confused.
Challenges for designing and servicing to high risk groups like old agers.
Threat and pessimistic behavior of people while processing their complaint regarding less/denial of payment of their claim.
Challenge to provide coverage for chronic illness and OPD charges.
5 CONCLUSION :
After the entry of private players, a layer of competition has been set in among all the players in the market. The customers are enjoying better product, competitive pricing, and quick and qualitative services. Trust, feeling of security and lower Premium is the main considerations for policyholders while selecting their insurer as the feeling that “my policy should be safe” remain in their mind.
Insurers need to efforts hard to give services on time, to treat the customers with respect and empathy, and to resolve issues.
4 https://www.mordorintelligence.com/industry- reports/india-health-and-medical-insurance-market
REFERENCES
1. https://www.ijltemas.in/DigitalLibrary/Vol.6 Issue8/36-43.pdf
2. Union Budget 2019-20
3. https://www.ibef.org/industry/insurance- sector-india.aspx
4. IRDA Annual report 2019 -20, and 201
