High operating and distribution costs, and hospital expenses as indirect costs could be the reasons affecting the insurance pricing.
Health insurance scheme is a costly affair for various sections of the society and technology needs to be leveraged to bring down the costs and enhance penetration, according to the chairman of Insurance Regulatory and Development Authority of India(IRDAI).
While addressing the 'Health Insurance Summit 2022' he said that high operating and distribution costs, and hospital expenses as indirect costs could be the reasons affecting the insurance pricing.
"We have to look at ways of reducing the expenses in order to make insurance affordable”, Panda said.
The head of Irdai suggested that adopting cutting-edge technical solutions to create customised health insurance policies using artificial intelligence may be the answer.
The official also nudged the industry to come up with pocket-friendly solutions as many times the out-of-pocket expenses for the consumables become painful for the insured despite
having a policy.
"In hospital bills, a lot of consumables are used in patient treatment. It's a small amount but painful for the customers. How do we stop that out of pocket expenses, what needs to be done...how do we take care of that? Can we come up with some kind of a solution?"
Moreover, he says that he understands the concerns of insurance providers about providing cover in such cases. Something can be done around the risk pool to cover risks. “It is time to ponder and come up with solutions,” he said, adding that the regulator is working on easing the caps on expenses management as demanded by the industry.
Health insurance providers are not able to sell insurance products because of inadequate hospital infrastructure, terming it a chicken-and egg situation, Panda said in tier II cities.
“Insurance companies and hospitals need to work together and investors need to invest in both these sectors,” he added.
Vinod Paul, member of Niti Ayog emphasised the importance of creating the best health insurance plans that exclude no one and include both the old and those with pre-existing conditions.
The Ayog in its report said that they have the ability to pay a nominal insurance premium but lack awareness of health insurance, or do not have access to suitably priced products.
According to Lav Agarwal, assistant secretary in the Ministry of Health and Family Welfare, the government is working with all stakeholders to ensure that India strengthens its position as a more desirable destination for medical tourism.
“The government is building a ‘Heel in India’ portal that will have the details of all accredited hospitals on a common portal to ensure hassle-free experience for the patients. The portal will also help in assessing the quality of service provided to the patient from his arrival up to post-discharge care. The focus has shifted from providing information to providing services and monitoring these services,” he added.
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 "Ways to make health insurance affordable, tips from IRDAI chairman")
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