Innovation in health insurance can address rising demand and accessibility challenges

Understanding the nuances of health insurance policies is crucial as we see a rise in the number of insurers. Insurers must have clarity on several aspects such as benefits, limits of coverage, restrictions and healthcare providers included in the plan. Syed Meraj Naqvi, CEO & Principal Officer, Riskbirbal Insurance Brokers reveals more

By Sonali Patranabish

How has the insurance sector adapted to include non-communicable diseases (such as cancer) under its cover?

The insurance sector has adeptly integrated non-communicable diseases (NCDs) such as cancer by implementing several strategies. Firstly, it has crafted specialised insurance products tailored to offer comprehensive coverage for NCDs. Secondly, the sector has embraced advanced underwriting techniques, ensuring a fair assessment of risks associated with NCDs. Third, healthcare providers now work together to streamline care for individuals with NCDs insurance companies started programmes. These aim to prevent NCDs in the people they cover. Last, these insurance companies give coverage to different NCD care parts. Providing diagnosis, treatment, and follow-up care, will support patients throughout their healthcare experience.

Lifestyle diseases such as hypertension and diabetes are becoming increasingly common. How has this affected both the insurer and health insurance provider?

More people are getting lifestyle diseases like high blood pressure and diabetes.

This affects insurers and health insurance companies in several ways:

First, more people are claiming insurance to treat these conditions. This increases the claim vs. premium ratio. Due to this, insurance companies must change their premium prices and coverage terms. They do this to handle the increased risk that comes with these diseases.

As a response, there is now more focussed on programmes that aim to prevent and manage these diseases. Health insurers are taking active measures to control pricing/cost for treating diseases caused by lifestyle choices. Insurance companies are also putting thought into programmes to help control ongoing costs related to health issues like high blood pressure and diabetes.

These long-term illnesses can become costly if not cared for appropriately. The plans aim to keep customers healthier in hopes of reducing future medical costs. This aims to improve the health of customers with these conditions. Using data analysis is also very important. It allows insurers to identify people at high risk of health issues early. Then they can offer specific help. This may prevent more serious and expensive health problems down the road.

How can companies further streamline the processes related to insurance claims to make health insurance customer-friendly?

To make insurance claims more effective and focus more on customers, insurance companies can do the following: First, they can introduce easy-to-use digital options that let customers quickly report claims and follow their progress step-by-step. Also, reducing required documents and less paperwork can streamline the claims process quicker, lessening the workload on customers. It is also important to communicate clearly and openly during the claims process, ensuring customers know what is happening at each stage.

Offering online self-help choices for managing claims lets customers deal with claims themselves, helping everything go smoother overall.

Furthermore, having dedicated support for helping customers ensures policyholders get quick and individualised help when required. Additionally, using automation to efficiently handle claims can speed up solving claims, cutting the time taken and boosting how satisfied customers feel. Insurance companies can use AI and other machine learning systems to automate regular claims for speedy settlements.

Lastly, teaching customers how to smoothly go through the claims process equips them with the needed knowledge and sources to interact with their insurance provider confidently, encouraging trust and satisfaction.

What are the measures that need to be taken to encourage health insurance among senior citizens?

There are some ways insurance companies can help more senior citizens get health coverage. Companies can make insurance plans just for seniors. These plans would focus on the medical care seniors usually need. This would make the coverage match what

seniors want. Offering discounts could motivate seniors to buy insurance. Things like subsidies or tax breaks could lower the costs of premiums and healthcare. This would make insurance more affordable for seniors. Plans should cover many medical services and treatments seniors may need. Wide-ranging coverage is important so plans meet seniors’ healthcare needs.

Making insurance plans easy to find through different ways, like online websites and meeting with helpers, makes sure seniors can explore all the options and make good choices about their coverage. Also, doing teaching programmes for seniors can help increase knowledge about how important health insurance is and the benefits it gives, letting them choose well for their healthcare. Also including coverage for health problems, they already have is crucial, as many seniors may have ongoing health issues that need regular medical care.

Finally, helping those taking care of seniors go through the insurance system makes sure seniors get the help and support needed to access the healthcare services they require, making it simpler to sign up for and use health insurance.

How can the tax structure be modified to boost health insurance?

Several approaches could help improve health insurance accessibility and affordability by adjusting taxes. One way is raising tax deductions for individuals’ health insurance premiums. This would directly relieve the financial strain of buying coverage. By making premiums more reasonable, people would be motivated to get health insurance. Next, giving tax breaks to employers who give their workers medical insurance, would persuade more companies to provide coverage. This helps more people get care and helps workers stay healthy. Also, giving refunds on taxes to folks with low incomes or to families could majorly help pay for medical insurance costs. This means even those with little money could get important healthcare.

In addition, introducing properly and promoting the Health Savings Accounts (HSAs) by raising contribution restrictions or permitting tax-free withdrawals for medical coverage premiums. This would promote financial readiness for medical crises and regular healthcare needs. Eliminating Goods and Services Tax (GST) on medical coverage premiums or decreasing the tax rate would additionally relieve the financial load on policyholders, making insurance more reasonably priced and urging enrolment.

Permitting employer contributions to staff health insurance premiums without taxes would provide extra monetary assistance for coverage, making it more achievable for employers to offer complete health benefits to their workers.

Finally, giving tax exemptions or motivations for insurance agencies offering health insurance strategies would urge progress and development in the market, resulting in a broader assortment of coverage choices for customers. In short, these changes in the tax system aim to improve the accessibility and affordability of health insurance, ultimately advancing better medical results for individuals and communities.


How can the government help insurance firms cover a wider range of health conditions/healthcare facilities?

The government can take several steps aimed towards improving the availability and usefulness of healthcare protection. Initially, by giving tax incentives for complete health insurance protection, the government may motivate insurance companies to provide plans that incorporate a broader scope of medical services and treatments. This could inspire individuals to choose broader protection, thereby promoting improved health results.

Additionally, smoothing regulations to make it easier to introduce new types of insurance would let insurance companies come up with and customise options to fit changing customer needs. Making regulatory steps simpler would speed up making and allowing new kinds of insurance ideas, encouraging competition, and leading to better choices for coverage.

Also, helping bring together public and private groups could improve access to specialised healthcare services that may not be readily available through regular insurance plans. By working together with healthcare providers, insurance companies can expand where they work and offer customers a broader range of medical locations and treatment possibilities.

Providing subsidies to businesses to help pay for their workers’ health insurance costs would encourage more people to have coverage through their jobs. This would help make sure more individuals can get full medical care through where they work. That would increase how many people can see a doctor and make medical care cheaper overall. It is also important for the government to put money into improving healthcare facilities. By upgrading buildings and offering more services, especially in places without many options, officials canhelp insurance companies cover a wider variety of medical needs. This helps give people in all areas a chance to get the treatment they need.


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