We will share our Point of view at the end of this report in Times of India , today.

This month, Kolkata-based Mr and Mrs Soubito Banerjee, who are in their 70s, saw their medical insurance premium almost double from Rs 32,000 to Rs 63,000. Chennai-based Annathai Gopalakrishnan (68) will pay Rs 58,000, up from Rs 29,000. In general, a health insurance cover of just Rs 5 lakh for a 65-year-old couple now costs Rs 84,000 per annum, as against Rs 54,000 five years ago.

Cost standardisation in health insurance need of hour: Vijayan

For many senior citizens living on a pension, the increase is stiff. At their age they cannot switch to another insurer, and a switch is pointless because the companies have raised rates in tandem. One big reason for the increase is the withdrawal of the 15% discount on the premium for no claims. There was also a family discount of 10%, available to at least two members seeking cover.

Less than 1% elderly have health Insurance

Together, that accounted for a significant 25% discount on the premium. These discounts were stopped by insurance companies last year after IRDA ruled in 2013 that those who had made a claim could not be charged higher premiums.

Though the discounts have been withdrawn for everyone, seniors take a larger hit because premiums rise with age. “My client has been paying insurance premium for more than 30 years. He used to be careful, paying small hospital bills from his own pocket to maintain the no-claim status,” a health insurance agent told TOI. That strategy will no longer work. G Srinivasan, CMD of New India Assurance Company, says insurers face losses of 300% in the senior citizen category. “The primary cause is medical inflation. Hospitals have no regulator, but we do. We are forced to increase prices for our viability.”

How to Pursue Health Insurance Claim , Click here

Another reason is that IRDA allows us to increase prices only once every three years. Our last price revision was in 2012,” added Srinivasan, “We’d still be making losses in this (senior citizen) portfolio. We’d have to increase the prices even more drastically if we want to break even.” V R Sehgal (name changed) is a worried man.

The 57-year-old pays Rs 43,500 per annum for the Rs 5 lakh health cover he bought for himself and his wife 25 years ago. After retirement, when his income will fall to Rs 20,000 per month, he will need to pay about Rs 60,000 per annum till the age of 65, and more than Rs 84,000 afterwards.

Data from Insurance Regulatory and Development Authority (IRDA) shows group health insurance provided to businesses is the most expensive segment for insurers (see graphic).

Corporate employees’ claims actually amount to more than what they pay as premiums while individual insurance payers claim the least.

Main Reasons of Premium hike

1. Slab wise premium Hike

Companies have kept a slab of 61 to 65 and 66 to 70 , i,e, they increase your premium after every five year. This jump is close to 20%. So if your premium change due to age coincide with Premium hike (say20%), then effective premium hike for you policy is close to 45%. Now, this will be a big shock to any sane person. There are policies available now , where there will annual premium hike of 2 to 3 %, which is better model.

2. Health Insurance Potability

People stick with one company for more than 10 years and dont even try to shift to other companies.

3. Policy with an older company

If you still stick with an Insurance company , which is more than 10 years old, you will bear burden to claim ratio accumulated over last 10 years., even if you entering right now.

4. Generic Medicines are not used

Everybody in India knows generic medicine cost 90% less , but there is no cohesive approach to use them at every hospital or clinic due to prevalent corruption in Pharma and Health Care sectors. Solution is available , but Government is not at all serious in effective implementation

5.Government Hospitals are not properly organised

Public i.e. Government hospital can play a big role in reducing cost of hospitalization. but no serious steps are taken. There is classic case of Jio, they have abrupt the telecom sector and now consumer has benefited a lot.

Solution :-

Dont try to think too much and spend so many hours googling with a hope of knowing everything over this intricate subject. You must hire a Health Insurance Consultant , who is unbiased professional and will advice you over a long term basis. Its better to trust an expert advice , instead of trying to learn the intricacies of insurance subject.

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