Topic 7: INSURANCE SECTOR: HEALTHCARE INSURANCE

The health insurance industry in India is expected to grow at a compound annual growth rate (CAGR) of 12.8%, increasing from $15.1b in 2024 to $23.8b by 2028, according to GlobalData. The share of health insurance in the Indian insurance market grew from 6.9% in 2019 to 9.5% in 2023, with a projection to reach 11.0% by 2028. The Indian health insurance industry is surging ahead, with projections for a 15% growth in 2024. This upward trajectory is fuelled by several key factors like medical inflation continues to drive demand for comprehensive health insurance coverage, with increasing public awareness of health risks and the importance of preventive care is boosting insurance uptake and lastly favourable regulatory changes are creating a conducive environment for industry growth. Building on the remarkable 17.8% growth witnessed in 2023, the industry is poised to maintain its momentum in the coming years.The Insurance Regulatory and Development Authority of India (IRDAI) introduced several significant changes to health insurance policies effective from October 1, 2024. These changes aim to enhance accessibility and affordability for policyholders. Here’s a summary of the key modifications in Health Insurance Policies: * No Age Restrictions: The most notable change is the removal of the maximum age limit for purchasing health insurance policies. This allows individuals of any age to buy health insurance, addressing a long-standing barrier that previously restricted coverage for seniors.

*Shorter Waiting Times: The waiting period for coverage of pre-existing conditions has been significantly reduced, making it easier for policyholders to access necessary healthcare services sooner.

*Comprehensive Plans: Insurers are now required to offer a broader range of coverage options, ensuring that policies cater to various healthcare needs, including critical illnesses and maternity coverage.

*Increased Security: Policies can no longer deny claims after five years, providing greater assurance to policyholders that their claims will be honoured as long as they have maintained their policy.

*Incentives for Policyholders: Insurers are encouraged to offer meaningful discounts on premiums, making health insurance more financially accessible.

*Flexible Refund Options: Policyholders can now expect more flexible refund policies, allowing them to receive refunds at any time under specified conditions.

*Enhanced Claims Process: A dedicated claims review committee will be established to handle disputes and ensure fair evaluation of claims, improving the overall claims settlement process.

*Streamlined Processes: The claims settlement process has been simplified to reduce the time and complexity involved in filing and processing claims.

These changes are designed to make health insurance more accessible and affordable for a wider range of individuals, particularly seniors who often face challenges in obtaining adequate coverage. By removing age limits and reducing waiting periods, the IRDAI aims to foster a more inclusive healthcare ecosystem that encourages more people to secure health insurance, ultimately enhancing financial protection against medical expenses. This initiative reflects a significant shift towards improving healthcare access in India, ensuring that individuals can obtain necessary medical coverage regardless of their age or pre-existing conditions.



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