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What is Health Insurance?

Health insuranceis a type ofinsurance


coverage that covers the cost of aninsured
individual's medical and surgical.

Health Insurance is a contract between an


individual/group and the insurer.

In health insurance terminology, the "provider"


is a clinic, hospital, doctor, laboratory, health
care practitioner, or pharmacy.
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Reasons for Health Problems

Physical Activity and Nutrition


Overweight and Obesity
Tobacco
Substance Abuse
HIV/AIDS
Mental Health
Injury and Violence
Environmental Quality
Immunization
Access to Health Care
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Rising Health Care Costs - Reasons

Specialty drugs, higher medical bills


Technology advancements
Cost of trained healthcare staf
Hospital infrastructure
Medical equipment
Cost of living
Inflation Rising drug prices
Super specialty doctors
Defensive Medical practice

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Why is health insurance essential?

Ambulatory patient services


Emergency services
Hospitalization
Maternity and newborn care
Mental health and substance abuse disorder services
(including behavioral health treatment)
Prescription drugs
Rehabilitative and habilitative services and devices
Laboratory services
Preventive and wellness services and chronic disease
management
Pediatric services, including oral and vision care
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Health Insurance Market in India


India consists of 52 insurance companies of which 24 are
in life insurance business and 28 are non-life insurers.
Among the life insurers, Life Insurance Corporation (LIC) is
the sole public sector company.
As per data reported on websites of various general
insurers, theGross Written Premium (GWP)for FY 2014-15
(i.e. the period April 2014 to March 2015) generated by 27
general insurance companies in India, is INR 87,625 crore
(USD 14.1 billion). The corresponding figure for last fiscal
(FY2013-14) was INR 79,688 crore (USD 12.8 billion). The
only company whose website does not show the required
details till writing this newsletter is Agriculture Insurance
Company of India (AIC).
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Health Insurance Role of Hospitals


Hospitals are the right place for creating awareness
of health insurance

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Issues & Challenges: Healthcare providers

A. Fastest growing population


B. Changing disease profile and Re-emerging diseases
C. Multilayered Healthcare System
D. Lack of or Absence of Infrastructure
E. Inaccessibility of Healthcare Services Source

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Issues & Challenges: Healthcare providers

A. No overcharging for insured patients


B. No fraudulent medical certification
C. Pre-existing diseases & treatment education
D. Classification of hospitals & transparency
E. No unwanted investigations, treatments, delays

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