Including you, there are three stand-alone health insurance companies in India. Since health insurance is your forte, what exclusive products or services can we look forward to?
To begin with, we have launched a basic health insurance policy. The idea behind launching a basic product is to increase penetration, considering penetration in India is only 2% and about 80% of people are still paying cash from their savings. So, clearly there is a need for a basic health insurance policy. Having said that, our focus is to engage people and have long-term relationships with them.
Damien Marmion, Chief executive, Max Bupa Health Insurance Co. Ltd
Does your policy has add-on features?
Our family floater health insurance policy offers maternity benefits and covers the new born from day one. In addition to this, we offer health insurance across all age groups. All our customers have to undergo underwriting norms, on the basis of which we give insurance. We have no age exclusions. All ages are covered, subject to underwriting norms.
So, even a 60-year-old, who may have a pre-existing ailment, can hope to get insurance from you?
Yes, although he will have to wait for four years before he can make a claim on account of a pre-existing disease. Refusal will happen only if it is in the interest of the customer. An elderly person who, say, has cancer will have to pay a huge sum of money as premium and cancer will not be covered for him for another four years. It will not be in the interest of the customer to pay such a huge amount. And we don’t load our premiums. Customers in the same age group will pay the same premium for a similar policy. We do not load an individual because of his specific disease. We call this community rating, which is a price for the population as a whole, irrespective of your medical history and claims. We do this because we feel it is important to be transparent in our terms and trustworthy in what we do.
Community rating would also mean high premiums since you have uniform premiums.
No, our premiums are on a par with what the market offers.
What about customer service? How would you handle claims?
We don’t have TPAs (third-party administrators) and instead have an in-house team. We service our customers directly. In addition to promising a smooth claim process, we also offer additional services, such as vaccination for a new born and regular health check-ups after the customer has been with us for two years.
Max and Bupa are well-known names in the areas of their expertise—healthcare and hospitalization, respectively. India still needs to cover some distance for effective integration between preventive healthcare, hospitalization and health insurance. What role do you see yourself playing here?
Enough emphasis has not been laid on consultative treatment. Medicines, consulting doctors and OPD (outpatient department) treatments are what most of us need but it is not covered by health insurance. We will continue to innovate in this space. We also have helpline numbers to assist our policyholders through medical consultation and features like health check-ups are steps in the direction of preventive care.
Portability is an issue, which the industry seeks to resolve through a common portable policy. Your comments.
I see little sense in porting individual policies. What makes sense is when a policyholder wants to port from a group policy by his employer to an individual policy. Insurers should be able to facilitate that shift and that is what we want to do. To begin with, we are planning to facilitate portability from group to individual policies in SMEs (small and medium enterprises). We will underwrite the whole group and if an employee decides to leave the company, we will offer him insurance individually. Often people feel reassured that they are covered by their employer, but once they leave the job they are not insured any longer. It is this gap that we would like to plug.
Damien Marmion is Chief executive, Max Bupa Health Insurance Co. Ltd