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Indian Health Insurance

Published by: Cygnus Business Consulting and Research

Published: Sep. 1, 2007 - 107 Pages


Table of Contents


1. EXECUTIVE SUMMARY

2. HIGHLIGHTS

3. GLOBAL INSURANCE INDUSTRY

4. INDIAN HEALTHCARE INDUSTRY

4.1 Market Size and Growth

5. INDIAN HEALTH INSURANCE INDUSTRY

5.1 Introduction

5.2 Industry structure & Overview

5.2.1 Regulatory body

5.3 Micro insurance

5.3.1 Regulations

5.3.2 Agents

5.3.3 Remuneration/commission

5.3.4 Micro health insurance

5.4 Health insurance industry segments

5.4.1 Social health insurance schemes

5.4.2 Community health insurance schemes

5.4.2.1 Community health insurance-based family protection plan (CHIFHP)

5.4.3 Employer-provided insurance schemes

5.4.4 Market-based schemes

5.4.4.1 Government products

5.4.4.2 Private products

5.5 Types in Health Insurance

5.5.1 Critical Illness

5.5.2 Indemnity

5.5.3 Managed Care

5.5.4 Overseas Travel

5.6 Growth of Health Insurance

5.7 Trends

5.8 Opportunities

6. HEALTH INSURANCE VALUE CHAIN

6.1 Identifying the players across the value chain

7. MAJOR PLAYERS

7.1 Introduction

7.2 Public Sector Non-Life Insurers

7.2.1 New India Assurance Company Limited

7.2.1.1 Products offered

7.2.1.2 Health insurance policies

7.2.1.3 Financial performance

7.2.2 Oriental Insurance Company Limited

7.2.2.1 Products offered

7.2.2.2 Health policies

7.2.2.3 Financial performance

7.2.3 National Insurance Company Limited

7.2.3.1 Products offered

7.2.3.2 Health products

7.2.3.3 Financial performance

7.2.4 United India Insurance Company Limited

7.2.4.1 Products offered

7.2.4.2 Health products

7.2.4.3 Financial performance

7.3 Private Sector Non-Life Insurers

7.3.1 Bajaj Allianz General Insurance Company Limited

7.3.1.1 Products offered

7.3.1.2 Health insurance policies

7.3.1.3 Financial performance

7.3.2 Royal Sundaram Alliance Insurance

7.3.2.1 Products offered

7.3.2.2 Financial performance

7.3.3 IFFCO TOKIO

7.3.3.1 Products offered

7.3.3.2 Health insurance policies

7.3.3.3 Financial performance

7.3.4 ICICI Lombard General Insurance Company Limited

7.3.4.1 Products offered

7.3.4.2 Health insurance policies

7.3.4.3 Financial performance

7.3.5 HDFC Chubb General Insurance Company Limited

7.3.5.1 Products offered

7.3.5.2 Health insurance policies

7.3.5.3 Financial performance

7.3.6 Cholamandalam MS General Insurance Limited

7.3.6.1 Products offered

7.3.6.2 Health insurance policies

7.3.7 TATA-AIG General Insurance Company Limited

7.3.7.1 Products offered

7.3.7.2 Health insurance policies

7.3.7.3 Financial performance

7.3.8 Reliance General Insurance

7.3.8.1 Products offered

7.3.8.2 Health insurance products

7.3.8.3 Financial performance

7.4 Specialized institutions

7.4.1 Star Health and Allied Insurance Company Limited

7.4.1.1 Health products

7.5 Other Intermediaries

7.5.1 Third Party Administrators (TPA)

7.5.2 Insurance agents

7.5.3 Insurance surveyors and Loss Assessors

8. REGULATIONS

8.1 Tax Regulations

8.2 Fixing health insurance premium according to region

8.3 Floor Rates for Rural Insurance

9. GROWTH DRIVERS

9.1 Demographic

9.2 Life-Style

10. ISSUES AND CONCERNS

10.1 Awareness

10.2 Frivolous claims

10.3 Processing Time and Administration

10.4 Cross selling activities by banks

10.5 Issues related to stakeholders

10.5.1 Hospital related issues

10.5.2 Insurance policies’ related

10.5.3 Policy holders

10.5.4 Related to insurance company

10.5.5 Government related

10.5.6 TPAs

10.5.7 General factors

10.6 Measures for Overcoming Challenges

10.6.1 Hospitals

10.6.2 TPAs

10.6.3 Policy conditions

10.6.4 Insurance companies

10.6.5 Government

10.6.6 General factors

10.6.7 Recent initiatives by IRDA

10.6.8 Health insurance working group (HIWG)

11. OUTLOOK ANNEXURE

1-BIBLIOGRAPHY ANNEXURE

2-LIST OF ABBREVIATIONS ANNEXURE

3-COMMUNITY HEALTH INSURANCE NETWORK ANNEXURE

4-LIST OF LICENSED TPAS IN INDIA

List of Tables

Table 3.1: Insurance premiums (USDbn)

Table 3.2: Real premiums growth in 2006 (In %)

Table 3.3: Premiums as percent of GDP in 2006

Table 4.1: Public healthcare physical infrastructure

Table 4.2: Major epidemics

Table 4.3: New entrants (FY2006 -FY2007)

Table 5.1: Commission paid to micro insurance agents

Table 5.2: Types of CHI schemes in India

Table 5.3: Premium structure

Table 7.1: Mediclaim policies sold and claims settled (FY2001-FY2005)

Table 7.2: Kisan card holder’s policies sales during FY2002-FY2005 and the claims reported

Table 7.3: Universal health policies sales (FY2004-FY2005)

Table 7.10: Rating for family packs under Medi Classic Policy

Table 7.11: Rating of groups under Medi Classic Policy

Table 7.12: Rating of groups under Medi Premier Benefits

Table 7.13: Premiums paid under the sum insured

Table 7.14: Premiums paid under the sum insured and age group (Diabetes Policy)

Table 7.15: TPA (infrastructure) - FY 2005 and FY 2006

Table 7.16: TPA claims data (FY 2005 - FY 2006)

Table 7.17: Fee structure of surveyor and loss assessor


List of Figures

Figure 4.1: Indian Healthcare Market Size

Figure 4.2: Pattern of Healthcare Expenditure

Figure 5.1: Health Insurance Market Size and Growth Rate (FY2004-FY2007)

Figure 6.1: Value chain of health insurance

Figure 7.4: Gramin policies sales (FY2002-FY2006) and claims ratio

Figure 7.5: Janata policies sold and claims reported (FY2002-FY2006)

Figure 7.6: Coverage of Universal policy and claims reported (FY2004-FY2006)

Figure 7.7: Coverage of Mediclaim policy and claims (FY2002-FY2006)

Figure 7.8: Coverage of Mediclaim policy and claims reported (FY2002-FY2006)

Figure 7.9: Coverage of Uni-Medicare policy and claims settled (FY2004-FY2006)

Figure 9.1: Indian Population according to their Age Group Figure 9.2: Indian per Capita Income

Figure 9.3: Growth in diseases related to life style (2006) Figure 9.4: Population involved in accidents

Figure 10.1: Awareness about types of insurance (2006)

Abstract

Health insurance market in FY2007 is estimated to be USD659.1m registering a growth of 30% compared with FY2006. In FY2006,the life insurance market occupied the major pie constituting 83.82% of the insurance market. The non-life segment is still in its growing phase with the market occupancy of 16.18%. In FY2006 health insurance covered only 1% of the population of the country and accounted for 1.2% of the total healthcare expenditure. However health insurance is growing very fast and according to Cygnus estimates health insurance premiums are expected to reach USD856.83m in 2007-08. This report has attempted to discuss the vital scenario in healthcare and health insurance market in India. A brief about global insurance industry in 2006, Indian insurance industry and health insurance industry overview are discussed. Growth drivers and issues of the industry are also covered. Major public and private players are covered in terms of their performance, products and outlook. Future outlook of the industry is also discussed.

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