New Delhi: Health insurance is a costly affair for many sections of society and technology needs to be leveraged to bring down the costs and enhance penetration, IRDAI Chairman Debasish Panda said on Tuesday.
While addressing the 'Health Insurance Summit 2022′ here, Panda said that high operating and distribution costs, and hospital expenses as indirect costs could be the reasons affecting the insurance pricing.
Pricing is probably very high leaving insurance cover unaffordable to many sections of society, the Insurance Regulatory and Development Authority of India (Irdai) chairman said.
"We have to look at ways of reducing the expenses in order to make insurance affordable," Panda said.
The IRDAI Chairman suggested that advanced technological solutions can be the way out. "Can we have some kind of a digital platform…we are also pro-actively attending to the major industry asks," he added.
He said the regulator is working on easing the caps on the expenses management as demanded by the industry.
The official also nudged the industry to come out with solutions which are pocket friendly as many times the out-of-pocket expenses for the consumables become painful for the insured despite having a policy.
"In hospital bills, a lot of consumables are used in patient treatment. It's a small amount but painful for the customers. How do we stop that out-of-pocket expenses, what needs to be done…how do we take care of that? Can we come up with some kind of a solution?"
Besides, there is a range of issues that needs to be covered for example coverage for infertility, coverage for genetics-related diseases, coverage for living care, and coverage for pre-existing ailments, Panda said, adding, for instance, a diabetic patient should not be denied coverage fearing heart attack in an inevitable.
While stressing that he understands insurance providers' genuine concerns about providing cover in such cases, Panda said something can be done around the risk pool to cover such kinds of risks. It is time to ponder and come up with solutions.
IRDAI is doing everything that can be done to increase the insurance penetration in the country, he said. Leveraging technology in the health insurance space from selling, and settling of claims to servicing of policies.
"Our lack of tie-ups with hospitals is proving to be hindering the accessibility of insurance services to the policyholders…we have recently facilitated insurers to have tie-ups with hospitals meeting standards, benchmark criteria as prescribed by their boards."
IRDAI has left it to boards of the companies how they can forge tie-ups aimed at not depriving people who live in tier III and IV cities.
"If the hospitals meet those benchmarks, minimum infrastructure required, manpower, they can go ahead".
Among others, he said Irdai has also brought about the regulatory sandboxing mechanism in which one can do on-ground trials of a product and if that proves a success, can be rolled out in a continuous manner.
"There were some bottlenecks in the regulatory sandbox mechanism which we have now revamped. It's there in the public domain and draft exposure…and very soon we are going to finalise it. And I am sure this is going to give a big impetus to the start-ups coming up with innovative solutions," Panda said.
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