Health care management and Health Insurance issues are in forefront of discussions at Policy Level/s, in Life/General /Health Insurance companies in India and elsewhere.

CII organized the first Health Insurance Summit on 5th October 07 in Mumbai.

Most of the important persons from Regulatory field, health service providers, TPAs, Reinsurance Companies, Heads of LI /GI / Health insurance companies, shared their views and under the CII insurance interest committee, four sub committees were formed to deliberate on above four important issues and feed in their thinking / deliberations and recommendations for discussions to health Summit being organized in New Delhi in November 07.

A number of decisions of consumer grievance redressal courts have come in during last month highlighting some of their issues regarding denial of claims on grounds of ‘Pre- existing’ diseases, or Senior citizens being declined Health Insurance due to age bars. IRDA responding by changing the definition of age for senior citizens etc.

There have been reports regarding National Life Insurer ( i.e LIC) declining group insurance to SAFAI KARAMCHARIS ( so called class IV) employees of PMC ( Pune Municipal Corporation) due to ‘larger’ deaths because of sanitation conditions , infections, drinking etc.

On the other hand, in the same city NGO’s organizing mutual self help health insurance at Rs.60/- per year for BPL persons by effectively utilizing Public Health facilities, and in the process providing health care to over 30,000 persons (and expanding) and still saving some money. (They donot even have actuaries)

Joint study done by FICCI –E&Y on state of Health Care industry in India was released on 15th October 07 and gives very good analysis of current state , growth and requirements, and issues like BUR/OT utilization being low, though ICU facilities are overstretched , innovative approaches regarding Health care Value Trips( Tourism) are surfacing in Chennai, Kerala and so on . on international front , Ms. Hilary Clinton ( likely Democratic nominee for US Presidential elections 08) who took great interest in Health Care issues as first lady is already positioning Health Care as a major campaign issue, while Bush Presidency struggles with a mixed policy ( or no policy) response . Health Care after retirement has been the major issue leading to strikes in large US corporations (e.g. recent UAW strike in USA – first such strike in two decades)

With Pension benefits itself becoming a major issue. Moreover, innovative products in health insurance and health care are being devised and offered in various parts of the world. In USA, Europe, Australia. In France e.g. there are number of ‘mutual’ health insurance products through NGO’s, Family (Takaful) products, and in India too.

In Health Insurance Perspectives part I, we had highlighted the views of Dr. Reddy, Chairman Apollo Group, Mr. C S Rao, Chairman IRDA, and Mr. Parekh of United Health care Group along with certain current developments in India.

Issues related to quality accreditation of hospitals, nursing homes etc. are crying for solution/s. We list below news, views on above issues and some recent cases. KNIPL welcomes readers to express their views. KNIPL would bring such seminars on Health insurance a once a month.

KNIPL Team