India a huge population of around 1.3
billion people, historically our healthcare sector has been largely
unorganized; people have always trusted the words and prescription of
their local doctor without much research or secondary consultations.
Due to this sector being largely unorganized and also because of lack
of proper medical facilities our country Healthcare insurance
sectorhas not generated the required attention it needs in a country
of such a huge population. People have always struggled to fulfill
their basic medical needs and according to most of them a proper
medical insurance is not one of them.
If we look at the figures, in 2011
3.9% of India’s gross domestic product was spent on healthcare, out
of this 3.9% medical insurance covers around 5-10% of expenditure.
This is one of the lowest even in developing countries let alone the
developed ones. This scenario is slowly but surely changing driven
mainly by the need of the people, increasing awareness and economic
liberalization. People are now starting to realize the value of a
proper healthcare policy. The entry of private players in this sector
and increasing advertisement through various channels has educated
people about the need to be financially covered for all medical
reasons. Most of these is also generated by medical policy provided
by the employers of the country.
In India there are broadly two types of
medical insurance
- General medical insurance
- Critical illness insurance
General medical insurance is the one in
which the provider covers cost of hospitalization, medical expenses
etc. for all the conditions for which the individual has been insured
under the policy. There could be different kinds of medical insurance
as well-Individual medical insurance, overseas medical insurance,
Group medical insurance are few broad categories. The group medical
insurance is the one in which any employer has a deal with a provider
to insure their employees for some medical benefits.
Critical illness insurance is one whichprovides only for critical conditions, threats of major ailments etc.
this is predefined in the policy as to which major ailments will the
person be covered for.
Most of these policies are tax
exemptible for the premium you pay for them by the government of
India as an added motivation for people to buy medical insurances.
The detail of this is under section 80D of the income tax policy.
Another thing to know is the third party administrators who are the
middlemen between insurers and customers; they help in claims
processing for customers and on the back end work with hospitals and
insurers.
In India People still are in involving
stage when it comes to choosing the medical insurance they should go
for but for the decisions that should be made following criteria
should be kept in mind:- sum assured, age, current health condition,
medical history , lifestyle, conditions covered in the policy, family
or individual policies, hospitals covered etc. In general it is
considered best to stick to simple and basic rules and not be jazzed
by few additional features of policies as in that case people end up
paying high premium only.
