The premium for health care policy increases by as much as 50% in a year and will ‘continue to rise’ | Business news

According to a survey by LocalCircles, 52 percent of personal health insurance owners said their premiums have increased by more than 25 percent in the past 12 months. Of the 11,000 health insurers that responded, 21 percent of health insurers indicated that the premium increase over the past twelve months was 50 percent or more, while 31 percent indicated that it increased by 25-50 per month. cents, it said.

Of the remaining respondents, 31 percent indicated an increase of 10-25 percent, while 2 percent indicated a premium increase of 0-10 percent and 15 percent denied any premium increase because it was “the same as last year.” Essentially, 52 percent of health insurers surveyed say their premiums have increased by more than 25 percent in the past 12 months, according to the survey.

LocalCircles said the insurance regulator has updated the definitions of pre-existing condition and moratorium period (MP) in health insurance policies from April 1, 2024. While the waiting period for pre-existing disease (PED) coverage in health insurance policies has been reduced from four years to a mandatory three years, the moratorium period of PED has been shortened from 96 to 60 months. Insurance companies have a ‘no look back’ policy during this period. This move comes at a time when consumers are struggling to get their health claims processed.

While the Irdai is yet to come up with a proposal to check rising healthcare premiums, policyholders are very concerned about a significant premium hike in 2024 after already experiencing high double-digit increases in the past two years.

The health insurance industry recorded a premium of nearly Rs 1,00,000 crore in FY24, reflecting a robust compound annual growth rate (CAGR) of 20 percent.

“A comparative study with the 2022 research results shows that the number of private health insurers that had seen their premium increase by more than 25 percent has fallen from 62 percent in 2022 to 52 percent this year,” the study said. . The year 2022 was marked by sharp increases in health insurance premiums, as many insurance companies predicted a new wave of COVID in 2022-2023 and increased premiums in anticipation.

“Although insurance companies want a significant increase in premiums every year, claims processing remains inefficient: one in two who submit a health insurance claim is struggling. It is time for Irdai to step in to rationalize premium hike and claims processing so that health insurance is citizen-centric,” LocalCircles said.

Nearly one-third or 1.6 lakh of the total 5.5 lakh pending consumer complaints received by the Ministry of Consumer Affairs relate to the insurance sector. In the latest LocalCircles survey published last week, 43 percent of citizens who had made a health insurance claim in the past three years explicitly said they had difficulty getting it processed. Complaints ranged from outright denials to exclusions to deductions and usually delays, the report said.

The survey received over 11,000 responses from personal health insurance holders across 324 districts of India. 67 percent of respondents were male, while 33 percent of respondents were female. 39 percent of respondents were from Level 1 locations, 30 percent were from Level 2 locations, while 31 percent were from Level 3, 4 and rural locations, the report said.

2.5 crore claims worth Rs 75,000 crore settled: GI Council

MUMBAI: According to the General Insurance Council (GI Council), the apex body of general insurers, the general insurance industry has handled claims for healthcare policies worth around Rs 75,000 crore involving over 2.5 crore cases in 2022-23. “This figure is expected to increase significantly in 2023-24 as efforts to streamline processes continue even further. Today, more than 60 percent of claims are processed on a cashless basis, and this is only expected to increase over time, especially with “Cashless Everywhere,” according to GI Council.

The GI Council said it has been continuously working with healthcare providers (hospitals) and TPA on the issue of streamlining customer experience and hassle-free claims filing, through joint dialogue and joint solutions.

Currently, policyholders can avail cashless treatment at more than 40,000 hospitals across insurance networks, the council said. “In addition, policy renewals are now guaranteed and individual premium charging based on health status is no longer allowed,” the report said.

“Much has already been achieved and we believe we are on the right track to completely revolutionize the way health insurance is viewed. The aim is to ease concerns and simplify people’s lives, giving them the confidence and support they need to meet their healthcare needs,” said Tapan Singhel, Chairman of the General Insurance Council.