Twilight gloom

The IRDA study makes not assure any decrease in mediclaim insurance premium for senior citizens, states Srikumar Bondyopadhyay

Seventy-two-year-old Nikhil Mukherjee had approached The Telegraph in April when he got to cognize that his coverage company was going to bear down him Rs 26,000 as insurance premium this twelvemonth against Rs 13,500 he paid last December to renew the medical insurance policy he bought eight old age ago.

Many aged people, including Mukherjee, started thinking of discontinuing their medical coverage policies as one coverage company after another started making wellness insurance unaffordable for what they called the "high hazard category" by raising insurance premium rates by more than than 100 per cent.

Panel formed

Concerned about the situation, the Insurance Regulatory and Development Authority (IRDA) had constituted a commission to look into assorted issues, including incidents where people above 60 old age were denied screen by many insurers, particularly the private sector ones.

The commission submitted its study early this month.

The report, however, have nil much to offer to senior citizens, except for the fact that it had recommended that no senior citizen should be denied a wellness coverage policy by any insurer.

The commission have recommended that insurance companies should look at a alkali insurance premium of Rs 3,000 (per annum) per Rs 1 hundred thousand sum of money assured at an entry age of 50 years.

The renewal insurance insurance premium for each subsequent twelvemonth with no claim would be increased by an age burden factor of 2 per cent of the alkali premium. A 60-year-old person who desires a wellness coverage with a sum of money assured of Rs 1 hundred thousand will have got to pay a insurance premium of Rs 3,600.

No change

The coverage premium charge per unit suggested by the IRDA-appointed panel is not very different from what National Insurance Company or United Republic Of India Assurance Company is charging for its senior citizen medical insurance schemes. Both the public sector insurance companies complaint a insurance premium of between Rs 4,100 and Rs 4,200 on a sum of money assured of Rs 1 hundred thousand for a 60-year-old who desires to purchase a fresh policy.

Another public sector insurer, New Republic Of India Assurance, is also coming out with a medical coverage policy exclusively for senior citizens with a insurance premium charge per unit of around Rs 3,800 per Rs 1 hundred thousand sum of money assured. Private coverage companies that offering person wellness insurance programs exclusively to senior citizens, however, complaint a higher insurance premium in the scope of Rs 5,000 or more than per Rs 1 hundred thousand sum of money assured.

Therefore, even if the committee's recommendations are implemented, the insurance premium cost for senior citizens won't come up down appreciably.

Low-cost plans

The panel has, however, suggested low-cost limited benefit programs instead of existing mediclaims that are mostly indemnity programs in nature. Benefit policy programs supply hunk sum of money amounts on diagnosing of a specified disease for treatment or surgery.

For example, in a infirmary hard cash plan, an insurance company pays a fixed amount for each twenty-four hours of hospitalisation.

Benefit bes after cost low pressure because they come up with in-built controls such as as less policy disposal and claim colony costs on the portion of the insurer. Misuse of coverage money is also low in these sort of programs as the insured acquires a fixed wage regardless of the existent outgo — any outgo over and above the amount would have got to be borne by the insured.

Cost control

Though the commission have identified affordability and handiness as the two most of import issues in senior citizen wellness insurance, it dealt more than with cost control measurements such as as co-payment by the insured, capping entitlements under outgo heads, introducing deductibles and co-insurance.

Co-payment, deductible and co-insurance average the insured also pays portion of the expense(s) covered under the coverage plan. According to the committee, these are all in-built measurements to command costs and abuse of coverage policies. Once these surplus costs are controlled, the insurance premium will come up down.

According to B.D. Banerjee, a member of the committee, a restructuring of existing merchandises is a more than likely result rather than an all-round reduction in insurance premium rates if the panel's recommendations are accepted.

So, if you don't desire to pay much, you will have got to be satisfied with programs that offering limited benefits such as as lone the cost of getting treatment in a general ward.

If you would wish to acquire your prostate gland operation covered during the first twelvemonth itself of the policy commencement, you will have got to pay higher.

In short, senior citizens will be offered a assortment of products, but will have got to take the benefits according to their paying capacity.