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Senior citizens can hope for better deal on health plans
Source- Financial Chronicle Aug 29 2012, New Delhi
By Sagar Sen
Private non-life insurance companies are mulling on health insurance plans targeted towards senior citizens. These plans will be for people above 60-65 years and planning to take a new health insurance plan. Already there are around six insurance companies, including three public sector insurers, who offer such products.
“We believe this segment is largely untapped and if correct products are introduced at proper prices, policyholders will show interest. We expect to launch a specialised senior citizen health insurance plan very shortly,” said Sanjay Datta, head of underwriting and claims, ICICI Lombard General Insurance.
Generally, the maximum entry age for an individual to take a health insurance plan is limited to 60 or 65 years, while in senior citizen plans, one can take a cover even if he is over 65 years. At present, few insurers including New India Assurance, United India Insurance, National Insurance, Star Health and Allied Insurance, Apollo Munich Health Insurance and Bajaj Allianz General Insurance are offering such products. (See table for maximum and minimum entry age)
“We are keenly monitoring the senior citizen health insurance segment. We believe a lot of innovation can be done there. However, lack of actuarial data is a major deterrent due to which the correct product pricing is a challenge,” said Suresh Sugathan, head of health administration team at Bajaj Allianz General Insurance.
Insurance companies perceive the senior citizen segment as a high-risk category, where the chances of claims are high and the quantum of claim amount is also high. The price of available health plans for senior citizens are on a higher side and some insurers may also hike the premium on policy renewal if there has been any claim during the year.
Premium of Apollo Munich Optima Senior for 65-year-old individual choosing Rs 3-lakh cover comes to around Rs 16,400.
“Insurance regulator is working very actively for health insurance to reach masses and senior citizen is a huge segment. In the absence of nationwide social security system, insurers may come up with products that reaches to a wider population. We are also considering few features that may suit insurance needs of elderly people,” said Arun Mehrotra, head of retail underwriting and product development, Iffco-Tokio General Insurance.
At present, there is a general exclusion of one to two years for coverage of cataract, benign prostatic hypertrophy, hernia, congenital internal disease, piles, sinus and stones. Dental treatment done for cosmetic reasons, injury or disease caused by war, vaccination for cosmetic reason, cost of glasses and contact lenses, hearing aids, congenital external disease or defects or anomalies, sterility, venereal disease, intentional self-injury are some of the permanent exclusions. The exclusions are similar to the exclusions on general health insurance policies.
Apart from high premium and medical conditions, another factor that de-motivates policyholders are the limits imposed on claim amounts. Senior citizen plans generally have co-payment clause where, in case of a claim, policyholders have to bear 20-50 per cent of the claim amount.
“In the event of a claim on a senior citizen plan, it is very unfair to ask him to share the hospital bills. Instead, insurers should come out with different variants of products where policyholders can choose between co-payment option or whole coverage,” said Suresh Kumar Sethi, vice-president, Insurance Foundation of India.
         
 
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