Soon, all health insurance policies will include coverage for outpatient treatment (OPD).
IRDAI Chairman Dr. Subash C Khuntia has asked non-life insurers and standalone health insurers to include OPD coverage in all health insurance policies to increase scope of coverage and attract a larger section of population. He was speaking at the virtual conference on health insurance conducted by CII.
He said that health insurance companies should offer primary and secondary care, OPD and preventive care to improve the penetration of the industry. So far, health insurance policies have offered coverage on tertiary care and hospitalisation. In addition, there are handful of policies, which offer coverage for OPD treatment; however, these policies charge higher premium amount, which most customers are not willing to pay.
OPD treatment includes coverage for doctors’ consultation fees and cost of medicines based on prescription.
Talking about the current state of the health insurance industry, Dr Khuntia said that large number of people in the age group of 40 years and 50 years have bought health insurance policies. This indicates that the industry is yet to attract millennials. Urging health insurers to attract millennials, he said that since millennials are unlikely to get sick, offering insurance to them is win-win for all stakeholders. And a better way to attract young population is to include OPD care as part of health insurance system, said Dr. Khuntia.
Further, he said that insurance should follow standard protocols to deal with various ailments, as there is perception among people that private insurers follow complex processes.
On penetration, Dr. Khuntia said that non-life penetration in India is just 1% of GDP compared to global average of 2.8% of GDP. Further, the penetration of health insurance in India is just 0.3% of the GDP.
Finally, he advised insurers to approach SMEs and unorganised sectors for health insurance policies to their workers to improve penetration.