As nuclear families rise, double incomes become the norm and health insurance needs for Indian households are transforming rapidly. Having adequate and customised protection for the family as it evolves, poses novel challenges for coverage selection.
Let's see how India's health insurance ecosystem will adapt over the next 3 years to align products with these changing profile risks and health expenses.
Enhancing Base Covers
Escalating treatment costs, usage of high-end diagnostics and the emergence of newer therapies will compel relooking at base protection levels.
Higher Mandated Covers
Government social health schemes and corporate policies will likely increase the mandated minimum sum insured per family from ₹50,000 currently to ₹1 lakh or more by 2024.
Introduction of Unlimited Plans
More insurers, especially online players, may launch unlimited covers without capping claim amounts for the family. Premiums could be performance-linked based on members' health scores.
Coverage of OPD and Wellness
Several health insurance plans for family will extend coverage to outpatient expenses beyond hospitalisation and built-in features for personalised health coaching, diet plans, fitness tracking, etc.
Top Ups and Super Top Ups
Fixed benefit or percentage top-ups of base covers allowing restoration of the utilised sum insured along with continuity benefits for migrating members may get popularised.
Specialised Care Networks
In addition to hospitalisation, insurers could develop affiliations with health services spanning:
Mental Wellbeing
Tie-ups with counsellors, therapists, support groups, rehabs/de-addiction clinics, etc., to provide covered mental health services either digitally or by visits.
Pregnancy and newborn coverage
Arrangements with gynaecologists, doctors, diagnostic centres and hospitals to offer cashless discounted services around pregnancy, maternity needs, newborn baby, etc.
Elderly Parents
Specialised network of senior care services, nursing homes, and home healthcare professionals aimed at the elderly dependents through customised such as step down or respite care etc.
Personalised Products
The rise of the nuclear family unit, double incomes and overseas stints are creating needs for tailored solutions.
Family Health Manager: Digital health locker providing customised health risk assessment for each insured member along with nudges and tips around health goals, activity levels, nutrition, etc., targeted to individual profiles.
Location-based Group Policies: Hyperlocal group policies based on pin codes allow small enterprises and communities to come together and benefit from discounted premiums due to pooled resources and group negotiations.
Overseas/Travel Options: Some policies may offer optional covers like worldwide liability, overseas assistance, repatriation, etc., targeted to frequent international travellers that integrate with existing family plans.
Wellness-linked Plans: Pay-as-you-live policies with premiums linked to health scores achieved through activities tracked via wearables - the higher the score, the greater the discounts. Adds incentive to adopting healthy habits.
Evaluating Health Insurance Provider
Claim Settlement Ratio: Analyse insurer's claim ratio and average turnaround times for processing reimbursements. A higher ratio and faster settlement represent robust processes.
Cashless Hospital Network: Look for extensive network coverage across your city for accident and emergency usage. Also, check if key specialised hospitals are included in planned treatments.
Customer Service Reach: Examine multiple access modes to customer care - call centres, email, mobile apps and online chat support. Check availability across extended hours and regional language choices.
Policy Renewal Flexibility: Evaluate ease of renewals, continuity provisions for covering new family members, and premium increase frameworks for renewed policies.
The Bottom Line
As urban Indians balance the cultural lineage of familial security with modern dynamics of nuclear families and overseas domiciles - customised, comprehensive and caring family health solutions will be the key task. India's insurance ecosystem will need to gear up on multiple fronts to address this emerging range of needs effectively when it comes to health protection.
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