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Navigating the Shifting Landscape of Health Insurance: Expert Insights

Navigating the Shifting Landscape of Health Insurance: Expert Insights

The realm of health insurance has been in a state of dynamic transformation over the past few years, and the global outbreak of the Covid-19 pandemic further accelerated these changes. 

Amidst the evolving landscape, two significant concerns have emerged as pivotal points of discussion: the steep premium hikes imposed by non-life insurers and the question of how much health insurance an individual should invest in. 

To shed light on these intricacies, we are joined by Deepti Bhaskaran, Head of Strategic Initiatives at Clinikk, on our podcast, Simply Save. Clinikk is at the forefront of developing a managed healthcare model by integrating outpatient care and health insurance into a single subscription plan.

With her extensive background in both journalism and the insurance sector, Bhaskaran provides a nuanced perspective on the challenges and solutions within the health insurance domain. Here is a summarized overview of her insights:

Optimal Health Insurance Coverage: Striking the Balance

The question of how much health insurance an individual should carry does not have a one-size-fits-all answer. Bhaskaran suggests that a health cover of Rs 5 lakh can serve as a decent starting point for an individual. 

To enhance this coverage, one can consider adding a top-up policy, allowing for greater financial protection against unforeseen medical expenses.

Determining the ideal health insurance policy amount depends on various factors, including your location (metro or non-metro), your hospital preference, and the structure of your family. 

For those considering a family floater policy, the number of family members must be taken into account when calculating the coverage required.

While maintaining an emergency corpus is advisable, the catastrophic nature of medical expenses can quickly erode one's savings. 

Bhaskaran emphasizes that relying solely on personal savings may not suffice for long-term medical needs. 

Having a health insurance policy serves as a safety net; when used to cover hospital bills, the coverage is reinstated, ensuring ongoing protection.

Revamping Premium Calculations for Fairness

Bhaskaran advocates for a fundamental shift in the way health insurance companies determine premiums for policies. 

She proposes that the focus should be on the age at which an individual initially purchases health insurance, rather than their current age. 

By considering how long a person has been insured, premiums can be more accurately assessed. 

This approach not only encourages individuals to secure coverage at a younger age but also contributes to reduced premiums over time, even as policyholders age.

The implications of this innovative premium calculation model extend to elderly citizens. 

If people are incentivized to purchase policies early in life and maintain coverage, the premiums for this segment tend to decrease in the long run, offering a more equitable and affordable solution.

Mastering the Art of Making Claims

The process of making insurance claims has long been a source of frustration for policyholders. 

Data from the Insurance Ombudsman reveals that the majority of complaints within the insurance sector pertain to claims-related issues. 

Bhaskaran's advice to avoid such disappointments is to thoroughly understand your policy's terms and inclusions. Misaligned expectations between policy coverage and the expenses being claimed can lead to undesirable outcomes.

To maximize benefits and ensure comprehensive coverage, Bhaskaran recommends investing in a comprehensive policy. 

While policies with lower premiums might seem attractive, it's crucial to examine the exclusions carefully. 

If a policy excludes a significant number of elements, it might not offer the comprehensive protection required to effectively manage potential medical costs.

In a rapidly evolving landscape, Deepti Bhaskaran's insights offer valuable guidance to individuals navigating the complexities of health insurance. 

From determining optimal coverage to advocating for fair premium calculations and mastering the claims process, her expertise sheds light on the path towards securing robust health coverage in an ever-changing world. 

As the health insurance domain continues to evolve, informed decisions driven by expert insights will play an integral role in ensuring financial security and peace of mind for individuals and families alike.


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