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Kerala - Kochi Printer Friendly Page   Send this Article to a Friend

Health policies gain popularity

R. Ramabhadran Pillai

KOCHI: People in the State are subscribing medical insurance policies increasingly these days. The convenience of getting medical assistance from a hospital without payment is attracting more and more people to mediclaim policies.

More than a dozen medical insurance groups are engaged in providing mediclaim policies in the country, but only four or five companies are actively involved in disbursing the policies in Kerala, according to sources in the insurance industry.

Life Insurance Company (LIC) has joined the sector by introducing a new policy recently. This indicates the potential of the mediclaim business. The services of companies such as TTK Healthcare and MedIndia have been utilised by some of the public sector insurance companies.

People up to 60 years of age are allowed to take the policies by most companies, but a medical check-up has been made mandatory for those above a certain age. Pre-existing diseases are not covered by the policy. This is one of the disadvantages of mediclaim policies. Nevertheless, increasing cost of medical aid is one of the key factors that attract people.

Cashless access

Cashless treatment is offered at specified hospitals, as per the conditions specified in the policy. The involvement of Third Party Administrators (TPAs) is another important aspect associated with the mediclaim policies.

The treatment plan would have to be approved by the TPAs prior to the treatment. This often creates confusion even though there is a toll free number to have access to the TPAs.

There had been opposition about the induction of TPAs by a section of the employees of the public sector insurance companies during the initial stages.

One of the reasons cited by the employees was the additional expenses incurred on account of the services of the TPAs, which gets reflected in the premium to be paid by the insured. But the TPAs’ role has been constantly monitored by the authorities and the initial hitches have been overcome, according to a leader of the employees association in the general insurance industry.

The Ombudsman could be approached in case of complaints.

Awareness low

The hospital authorities as well as the insurance sector agree that awareness is low and there is much scope for expansion. The days ahead will surely see more hospitals and more people coming under the purview of the medical insurance schemes, they say.

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