Home / Brand Stories / It’s high time for OPD Insurance in India: LivLong

Healthcare has garnered much needed attention in recent times which augurs well for the sector as a whole. However, there are some areas which would require special mention, namely OPD insurance, which could be a game changer in the larger scheme of things.

With respect to the upcoming budget, it would be wonderful to see much needed changes regarding OPD Insurance, with focus being put on:

Accessibility of OPD Insurance

Making OPD insurance accessible to all sections of society, without burning a hole in the pocket, would by far be the best approach towards building this aspect of the industry. Currently, only tier 1 cities have access to quality healthcare, and a heavy-set change is the need of the hour for the same.

Predictability of pricing in the OPD sector

Predictable pricing could be a win-win situation for both patients & healthcare providers. It promotes transparency and fairness in the OPD sector, as patients are aware of the cost of the services they are receiving and can make informed decisions. Predictability in the OPD sector is essential for maintaining an affordable, accessible and efficient healthcare system.

Accessibility and predictability in OPD insurance could be brought about with a few radical changes such as listed below:

The government could develop and enforce stringent guidelines along with adherence so that the outcome benefits the consumer, safeguarding his interests and providing transparency in the industry.

IRDAI policies must not only encourage small investors to invest in insurance and scale it further but be lucrative enough to attract big investors.

Most insurance companies have started from tier I, where income and accessibility are high. However, distribution could be structured in such a way that even tier II and III cities gain accessibility.

Small unregistered companies, which are not under any regulation, need better compliance and guidelines so that it covers the risk the consumer might encounter in future.

Stringent guidelines and compliance will act as a barrier to entry for fake and inappropriate vendors. Only the genuine, which abide by the law and are dedicated to serving the industry, will enter with quality healthcare and better accessibility, protecting the end-consumer.

IRDAI, the premium authority in the sector, could ensure compliance by active players in the market providing insurance. It could also help maintain the industry balance so that the companies can scale up and provide new and innovative products.

According to the Economic Survey of 2022*, the expenditure on public healthcare was 2.1% of GDP in the year 2021-22. However, this could be increased to 2.5% by 2025, as recommended in the National Health Policy, 2017**.

Promoting OPD insurance in India requires a multi-pronged approach that includes awareness campaigns, government incentives, and collaboration with healthcare providers, innovative products and delivery models. With the right combination of initiatives, OPD insurance has the potential to become a critical component of the Indian healthcare system, improving health outcomes and promoting financial stability for all.

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