Bengaluru: Dr Devi Shetty’s Narayana Health, which became the first hospital chain in India to also own an insurance company, will introduce a new insurance policy for senior citizens with coverage of up to Rs 1 crore, available at an affordable premium. Unlike some of its peers, the insurance for senior citizens will cover pre-existing conditions after conducting a comprehensive health screening before enrolling them in the insurance scheme. The health scheme is designed to support senior citizens throughout their entire lives, with no upper age limit imposed.
About 15% of the heart surgeries done in India are performed by Narayana Hrudayalaya, and a substantial 30% of the surgeries are on senior citizens.
“We also want to cover people who had heart surgery or angioplasty before. We will also offer top-up insurance to people who are already insured but their coverage could be anywhere between Rs 5 lakh to Rs 10 lakh. We want them to be covered up to Rs 1 crore,” said Dr Shetty to TOI. The policy aims to provide coverage for individuals who have undergone cardiac procedures such as heart surgery or angioplasty. Additionally, Narayana Health plans to offer top-up insurance options for those who already have existing insurance coverage ranging from Rs 5 lakh to Rs 10 lakh, with the goal of increasing their total coverage up to Rs 1 crore.Amit Chhabra, chief business officer – general insurance at Policybazaar, said the Indian insurance industry has witnessed innovation recently because of insurers’ innovation and supportive regulatory reforms. “One such move has been to introduce the Rs 1 crore sum insured category in health insurance. A high sum insured like this can help growing families with less disposable income combat the medical inflation, which currently stands at 14% and is almost double the general inflation. Leading insurers like ABHI, Bajaj, Care, Niva Bupa and Tata have all championed this innovation.”
Chhabra said the ever-increasing healthcare costs have had a grave impact on the medical needs of senior citizens who may not have access to a regular stream of income and have very specific medical needs. “Recent innovations specifically cater to these needs, offering day 1 coverage for chronic conditions like asthma and hypertension. Insurers are also increasingly becoming more accommodating of heart and diabetes-related risks.”
Even as the govt is mulling reducing the GST rate on health insurance products, he said, “Ideally, the govt will be better off without GST on health insurance because as more people buy health insurance, it’s less expensive for the govt,” Shetty added.
There are three important stakeholders in healthcare delivery — hospitals, health insurance companies, and patients. Unfortunately, hospitals do not trust health insurance companies, health insurance companies do not trust hospitals, patients do not trust both entities, and both entities do not trust patients. “This must change. Health insurance companies, hospitals, and patients can learn to trust each other if we build a different system,” said Shetty.
The hospital’s flagship insurance product, called Aditi, offers comprehensive family coverage for an annual premium of Rs 10,000, with a sum insured of Rs 1 crore for surgeries and Rs 5 lakh in treatment costs at Narayana Health network hospitals. Aditi was initially launched in four districts around Mysuru as part of a pilot project, before expanding to other parts of Karnataka. The pilot project aims to cover 1 lakh to 2 lakh people in the first phase of the rollout. Narayana Health has already soft-launched the scheme in Bengaluru and will be rolling out the scheme in Kolkata and New Delhi next year.
However, Pankaj Nawani, CEO of CarePal Secure, believes that health insurance products typically come with waiting periods, unless the underwriting process is thorough. “While the recently announced product boasts an appealing price point, there is a lack of comprehensive information available,” he said.
Shetty said even mature markets, including the US, cannot afford free healthcare with taxpayers’ money. Some other countries have a very high tax-to-GDP ratio between 25% to 45%, whereas our tax-to-GDP ratio is about 11.2%, and they spend between 10% to 18% of GDP on healthcare while India spends about 2.1% of GDP on healthcare. “We are in an enviable position to offer health insurance that is affordable to all citizens.”
Many people, Shetty said, have silent ischemia, a condition where individuals experience ischemic episodes without any noticeable symptoms or pain. Shetty said that the company has set up a 15,000 sft advanced screening centre in one of the tech parks in the city with facilities including ultrasound, CT scan, mammogram, pap smear, and other diagnostic facilities. “Why do fit people not undergo preventive checkups? This is part of our effort to drive preventive checkups. If people don’t want to go to the hospitals, we will come to your place of work,” he said.
