Max India in JV with UK health insurance major

NEW DELHI: Healthcare and insurance company, Max India, has forayed into health insurance through a joint venture with UK health insurance major, British United Provident Association (BUPA). Max India will hold 50% in the JV, promoter and chairman Analjit Singh and his family will hold 24%, and BUPA will hold the remaining 26%, reports Our Bureau.

BUPA has the option of raising its stake in the JV to 50% when the sector opens up. The JV, Max Bupa Health Insurance, will initially invest Rs 100 crore, a Max India release said. This is Max India’s second venture in the insurance sector. It already has a 26:74 general insurance JV with US-based New York Life Insurance.

“We have been interested in the health insurance sector for a long time, but were waiting for some regulatory reforms to take place. Our decision to partner with BUPA was based on the synergies and unique strengths that BUPA brings to this venture,” said Max India chairman, Analjit Singh.

. BUPA has the expertise in creating and delivering differentiated health-insurance products and a proven ability to operate in and adapt to international health care markets. Through Max India, we will capitalise on our knowledge and experience in the health and life insurance sectors,”

Mr Singh told ET that BUPA was the market leader in the health insurance sector in most of the market it operates. ‘It has a 45% market share in the UK health insurance market. It is the market leader in Spain, in Europe and in emerging markets,’’ he said.

BUPA group chief executive, Ray King, said, “The Indian health insurance market has massive potential, with a growing, young, population. We believe that many of its citizens will be looking for the high quality of care and customer service that Max BUPA will be well placed to offer.”

Health Insurance is a under penetrated market in India, a country where about 70% of the healthcare spend is in the private sector. According to industry estimates, the country’s healthcare spend is expected to touch Rs 3,33,480 crore by 2012 from Rs 1,53,330 in 2006. But less than 2% of the country’s population have any private health related insurance covering.

Source: Economic Times

Insurance Co cannot deny reimbursement

An insurance company cannot escape the liability of reimbursing expenses incurred on life saving external aids like pacemaker and C-PAP (Continuous Positive Airway Pressure) machine to patients, the Delhi Consumer Commission has said. "Those equipments are reimbursable which are essential for treatment of disease and necessary for saving life, for instance pacemaker and artificial limbs," Commission President Justice J D Kapoor said. The Commission rejected contention of National Insurance Company Ltd (NICL) that the terms of the insurance policy did not allow it to reimburse the cost of a machine which is used as an external aid. "Any beneficial legislation or for that purpose beneficial contract like the insurance has to be provided and receive beneficial interpretation and if there are more than one interpretation available then that which goes in favour has to be accepted," the Commission said. The Commission's consumer-friendly observations came on an appeal of the NICL against an order of a district forum directing it to pay Rs 1.07 lakh with interest to Gian Chand, a resident of Karol Bagh here. The Commission partly allowed the appeal and waived off the interest on the awarded compensation. Chand, who was suffering from chronic snoring trouble, was denied reimbursement claim by the NICL for C-PAP. "So far as C-PAP is concerned, any patient is having a disease cannot survive long, if such system is not used (by him). Rather, he can die any moment if such a device is not used... Thus, meaningful interpretation of the Insurance clause has to be provided," the Commission also comprising member Rumnita Mittal said.
Source-Economic Times

HEALTH IS WEALTH FOR INSURANCE GIANTS

New Delhi: Post de-tariffing, if fire and engineering are making holes in the balance sheets of non-life insurance companies, it is the retail business — health and motor — that is raking in the moolah. The two sectors account for almost two-third of the Rs 28,126.4 crore general insurance industry.

While the health insurance premium for non-life insurers shot up 55 per cent to Rs 4,969 crore in 2007-08, motor insurance posted a more modest 20 per cent growth during the year. The industry as a whole grew just 12.5 per cent during the year compared with Rs 24, 998.4 crore in 2006-07.

According to an IRDA report card, Reliance General Insurance — with nearly 7 per cent market share — has booked the highest jump in health insurance premium. It collected Rs 257.62 crore, up 307 per cent as against Rs 67.69 crore in 2006-07. The biggest non-life insurer, state-owned New India Assurance, collected nearly Rs 114 crore, 58 per cent more than the previous year. For other major players such as National Insurance, United India and Bajaj Allainz too, the health business premia rose by 105 per cent, 60 per cent and 53 per cent, respectively.

"With the fall in the prices of engineering and fire premia, insurance companies are now focusing more on the retail lines – motor and health," says T Ramalingam, head (underwriting), Bajaj Allianz General Insurance. "Before de-tariffing, group health insurance was bundled with property insurance and offered at a subsidised rate. With de-tariff kicking in, insurance premium for property has come down and medical insurance costs has risen. This has further led to a rise in premium collection for health insurance."

The health insurance sector in the country has witnessed rapid growth since insurance liberalisation in 2001. The premium has grown from Rs 774 crore in 2001, to Rs 3,300 crore in 2006-07. The sector is expected to maintain momentum and grow at a CAGR of 40 per cent in future.

"De-tariffing has led to hectic competition and at present market-driven rates prevail. Owing to this, everybody is slowly shifting to the more stable segments, i.e., the retail segment — motor and health. Health segment is growing fast at the rate of more than 30 per cent. This 30-35 per cent growth rate is expected to continue for the next two-three years," says M Ramadoss, chairman and managing director Oriental Insurance.

Motor insurance is further classified into own damage and third-party. While premium for own damage motor insurance saw a sluggish growth at 8 per cent, it is the third party motor insurance that booked a 50 per cent rise in premium collection. “The spurt in the premium collection for third party motor insurance is primarily due to the creation of pool from April 1, 2007,” says Rahul Aggarwal, CEO of Optima Insurance Brokers. “The move has encouraged a lot of small companies for third party underwriting.”

Source: Suneeti Ahuja
The Indian Express

FEATURES OF NEW HEALTH INSURANCE SCHEME EXPLAINED

Tuticorin: The district administration conducted an awareness programme at the Treasury here on Wednesday to highlight the salient features of the ‘New Health Insurance Scheme’ (NHIS) introduced by the State Government last month.

The scheme is being implemented under the control of Director of Treasuries and Accounts. Addressing government officials, D. Ganesan, District Treasury Officer, said that the scheme, which replaced the Tamil Nadu Government Employees’ Health Fund Scheme, offers wider coverage extending health insurance to employees of all departments, local bodies, public sector undertakings, statutory boards and state universities, and their families.

“About 21,000 employees and their families in the district are being benefited by the scheme,” he added. The family members of the employees entitled to the coverage include spouse, children till they got employed, married or attained 25 years, whichever was the earliest, and parents if the employee was unmarried.

“The new package provides cashless assistance at an affordable premium of Rs.25 a month, which is being deducted from the employees’ salary, instead of the reimbursement model followed under the earlier scheme,” Mr. Ganesan said.

The insurance company identified to provide the coverage (Star Health and Allied Insurance Company) would reimburse the medical expenses up to Rs.2 lakh for a family for a block of four years, directly to the ‘approved hospitals’ identified for the scheme.

In the district, Sundaram Arulraj Hospital, K. J. Nursing Home, Rajam Nursing Home (all in Tuticorin town), and Aarthy Hospital, Venkateswara Hospital (both in Kovilpatti), would provide medical assistance.

The insurance company would issue identity cards to all the employees carrying details about them and their family members before August 31, to help them display their identification while availing treatment at the said hospitals.

Mr. Ganesan said that cost of medicines of laparoscopic, cardiac and emergency life saving surgeries, doctor fees, room charges, diagnostic charges and dietary charges, incurred at the ‘approved hospitals’, would be reimbursed. The District Public Relations Officer, S.R. Sarathy, was present.

Source: The Hindu

INSURANCE CO TO PAY FOR STOLEN JEWELLERY

New Delhi: In an unusual case, state consumer commission has directed Oriental Insurance Company Ltd to pay Rs 10.5 lakh for rejecting the claim of a woman whose jewellery was stolen from her car while she met with an accident in which 6-8 cars rammed into each other.

The insurance company rejected the claim on the grounds that the insured had not taken reasonable care while coming out of the car when the accident took place. It argued that and the theft from the car was an ‘exception’ since the car was not parked when the jewellery was stolen.

Presiding over the commission, Justice J D Kapoor said: ‘‘It is understood why the occupants had to come out during the accident from their car, which could not be avoided. It was a natural reaction from the complainants to leave the car oblivious of the fact that something would go wrong. Therefore it was not correct on the part of the insurance company to invoke exception clause of the policy.’’

In this case, Usha Anand, an NRI had removed jewellery from the locker on August 1, 2001. With the jewellery in a bag, she was driving with her sister and as they reached Defence Colony flyover, the accident took place. Usha and her sister got out of the car to quell the ensuing chaos, but returned to find the jewellery missing.

An FIR for missing jewellery was lodged but the case was closed on September 28, 2001. The complainant submitted documents to the company for claiming insurance for the stolen jewellery which was rejected and closed as ‘‘no claim’’ as the company stated it shall not be liable for ‘‘theft from a car except one in which all the doors, windows and other opening securely locked and properly fastened.’’

Source: Times of India