More bang for buck: Insurers now pay
Star Health and Allied Insurance now cover over 200 day care procedures. Similarly, HDFC Ergo provides insurance for over 100 day care procedures.
CHENNAI: Medical insurers have increased the number ofday care procedures covered in policies — a marked departure from the standard mediclaim norm that required hospitalization or 24 hours stay in a medical centre for the cover to come into force.
Star Health and Allied Insurance now cover over 200 day care procedures. Similarly, HDFC Ergo provides insurance for over 100 day care procedures. "Increasingly, health insurance covers are becoming more inclusive as the industry gains more experience from claims data and history," Mukesh Kumar, head, human resource, marketing and strategy planning, HDFC Ergo said.
Industry observers also state that another reason that fuelling the coverage of day care procedures is that mediclaim as a product is over 25 years old, having being conceived in 1985. "Over the years, advances in medical technology have ensured that many surgeries have become a day affair now and the list is only set to grow," Rahul Aggarwal, CEO of insurance advisory Optima Insurance Brokers said.
Added V Jagannathan, CMD of Star Health, "While mediclaim was built with checks and balances to ensure one was not taken for granted at the delivery point, over time, systems, records and technology have improved, which ensure a person can walk in and out of surgery on the same day itself."
Also, a push from the regulator Irda (Insurance Regulatory and Development Authority) last year urging insurers to launch more day care health insurance covers has also helped the cause. Also, under the new guidelines for health insurance issued last year, the regulator has laid down standard definitions of 46 commonly-used health insurance terms such as day care treatment, co-payment and domiciliary hospitals.
But while some day care surgeries can be more expensive on account of the latest technology, medical equipment and procedures (like minimally invasive ones), officials state it leads to better claims processing and management and thereby cost saving.
For instance, insurers don't have to grapple with the inclusion and exclusion component of room rent which would otherwise be necessitated on account of a long stay in hospital post recovery.
"From the insured standpoint, even though such surgeries can take put a large part of the sum insured in one go as they are more expensive, but there is costs savings from the bed charge and nursing standpoint. In fact, many hospitals now have separate day care procedure wards now," Renuka Kanvinde, associate vice president, health insurance, Bajaj Allianz General Insurance said.
Star Health and Allied Insurance now cover over 200 day care procedures. Similarly, HDFC Ergo provides insurance for over 100 day care procedures. "Increasingly, health insurance covers are becoming more inclusive as the industry gains more experience from claims data and history," Mukesh Kumar, head, human resource, marketing and strategy planning, HDFC Ergo said.
Industry observers also state that another reason that fuelling the coverage of day care procedures is that mediclaim as a product is over 25 years old, having being conceived in 1985. "Over the years, advances in medical technology have ensured that many surgeries have become a day affair now and the list is only set to grow," Rahul Aggarwal, CEO of insurance advisory Optima Insurance Brokers said.
Also, a push from the regulator Irda (Insurance Regulatory and Development Authority) last year urging insurers to launch more day care health insurance covers has also helped the cause. Also, under the new guidelines for health insurance issued last year, the regulator has laid down standard definitions of 46 commonly-used health insurance terms such as day care treatment, co-payment and domiciliary hospitals.
But while some day care surgeries can be more expensive on account of the latest technology, medical equipment and procedures (like minimally invasive ones), officials state it leads to better claims processing and management and thereby cost saving.
For instance, insurers don't have to grapple with the inclusion and exclusion component of room rent which would otherwise be necessitated on account of a long stay in hospital post recovery.
"From the insured standpoint, even though such surgeries can take put a large part of the sum insured in one go as they are more expensive, but there is costs savings from the bed charge and nursing standpoint. In fact, many hospitals now have separate day care procedure wards now," Renuka Kanvinde, associate vice president, health insurance, Bajaj Allianz General Insurance said.
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