How healthy is health in Indian health insurance policy? Most health insurers today are just providers for financial safety

By Akash Shukla

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Health insurers had a limited role to play in the Indian healthcare industry so far. Traditionally, this was because health insurance services earlier were a monopoly which could only be provided by government-owned public sector units.

The mediclaim policies they offered were poorly crafted because these were treated as "lost fortune'. The insurance companies expected to lose money on these policies, but no one really cared because medical costs were so low. However, times have changed since medical costs have started going through the roof. Also, once the sector was privatized, insurers realized that this could be a hugely profitable business and lots of private players now want to get in so that they can also get their own slice of the cake.

This is all for the best because health insurers are the ones who are supposed to actually protect their customer's health. However, unfortunately, most health insurers today are just providers for financial safety and there is very little "health' in health policies.

They will reimburse claims after the patient has fallen ill and in case of surgery, but there is very little which they're doing to help the patient in acquiring the right medical care.

Ironically, one of the hurdles they have to deal with is doctors. Because patients would much rather trust the doctor who's talking to them face to face, rather than the information which comes from a faceless health insurer, most health insurers have found that most of their customers are not very interested in the patient education content which they provide.

Many-a-time even the HR blunts the effort when the insurer tries to reach out to the corporate with the "free patient education' materials even if it's a value addition service. The HR department would not directly allow them to interact with the employees. Since no direct communication details are shared, the communication with the insurance company is limited.

The pervasive irony in the perception of corporate employees is still the same—"health insurance adds little to their health!' But with the advent of smart phones, it's now possible to engage directly with their customers as alternate means are plausible now.

Adapting to the Indian conditions and repositioning of health insurers would open doors to opportunities galore. This repositioning should be pretty much humane in nature and this message should be project for the insured: We will assist you in finding the best doctor in case of any medical exigency.

This reinvention of self would take this industry to the next level as this pretty much is the imminent need of the hour. Only restrategizing can persuade customers to change their mind. With a better use of call centres and new media platforms like e-mail, whatsapp or SMS, the channel between insurer and the customer would remain open.

The health insurers must be treated as health mentors by their customers and only then they will reach out to the former in case they have a backache, fever or any other transgression. The fact that a round-the-clock helpline is at their disposal will be quite reassuring for a person who is ill in any way.

This outlet with the customer would provide the insurer with the opportunity to educate the patient. They can assist their appointments with the doctors and this is how the trust is built. Once the customer begins to put his faith in this "unbiased assistance', they will avail the services that are offered. The long haul to the entire pitch is that it is much easier to take care of a well-informed patient as they would have logical and pragmatic expectations from their medical treatment.

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Akash Shukla

Sr. Features Writer, Entrepreneur India

With four years of journalistic and editorial experience from two leading English dailies, namely, The Pioneer and Hindustan Times, Akash dabbles in Applied Linguistics and mainstream journalism. His interests include book writing, travelogues, Gender Studies and Shaivism. The author is a senior features writer cum sub editor at 'Entrepreneur Online' and has a dual masters in journalism and English Language Teaching (ELT).

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