Poised to undergo key shifts by 2024. With rising costs, growing incidence of critical illnesses and an ageing population - having adequate protection against health expenses becomes paramount.
Let's examine how family health insurance is likely to evolve on key dimensions around coverage, product customisation, channel outreach and adoption of technology.
Sum As India continues making strides in healthcare access and delivery, family health insurance is Insured and Healthcare Costs
As more advanced medical procedures get mainstream access, treatment costs will rise sharply. This renders choosing an adequate sum insured crucial for family health policies.
Inflation Indexing
Many insurers now offer Super Top-up plans, allowing automatic sum insured to increase by 10-15% yearly, keeping pace with medical inflation. More family plans will incorporate indexed covers by 2024.
Preventive Care
With easier access to preventive testing, health plans will seek to incorporate outpatient and OPD covers focused on screening and diagnosis as value-adds. Tax benefits on these will drive adoption.
Senior-specific Enhancements
Special senior citizen plans to offer features like zero co-pay, higher room rents, and lifetime renewals will get more standardisation and acceptance from age-specific and senior-focused versions.
Revised Regulatory Framework
IRDAI is evaluating options to increase the minimum health cover requirements for each family member above ₹50,000 - this could make low-sum insured plans redundant.
Covering Pre-existing Conditions
Health insurance plans for family, covering pre-existing illnesses for dependents like parents, will need more flexibility from insurers. Some expected relaxations:
- Lower Waiting Periods: Insurers mandating 2-4 years exclusion for certain conditions may bring this down to 1 year as competition intensifies.
- Specific Illness Covers: Standalone critical illness plans covering procedures like cancer, and special surgeries may allow limited family coverage for spouses based on specific requirements.
- Protection for Elders: Group policies for seniors above 70 years by insurance providers, along with state-sponsored schemes, can expand coverage for elderly dependents against pre-existing conditions.
Customised Protection
Nuclear families, double-income homes and overseas dependents - all herald demand for tailored family health plans.
Senior Care Plans
Specialist plans for elderly family members providing covers around assisted living, home care, rehabilitation and physiotherapy are expected to be launched by both insurers and care startups.
Women-centric Plans
Female policyholders will see plans allowing resets/restores of the sum insured for pregnancies, newborn covers and health benefits targeted specifically towards women.
Distribution and Engagement
While digital will dominate health policy distribution for direct players, agency channels will continue driving volumes for traditional insurers.
- WhatsApp Commerce: Using WhatsApp for customer outreach, policy purchases, and claims assistance will gain significant traction, given the chat app's over 500 million user base in India. Insurers have already initiated pilots.
- Online Aggregators: Price/feature comparison sites for health insurance will aim to capture leads online and route them to insurers, similar to models in travel, lending and e-tail.
- Assisted Buying: Insurtechs focused on assisted buying for multiple financial products, including health policies, are emerging. Their platform tools hand-hold customers on product selection and paperwork.
Tech-enabled Operating Models
The end-time expectation is that technology innovations will enhance efficiencies and personalisation across the policy management lifecycle.
Telemedical Consultations
Insurers have already initiated pilots to provide telemedicine consultations, app-based fitness tracking and health bot interactions as engagement tools for policyholders seeking convenience.
Return on Premium Plans
Concepts like life insurance plans promising maturity returns are being evaluated for the health vertical as well. This can incentivise policyholders to display responsible behaviour through rewards.
The Bottom Line
For policy buyers, family health insurance is poised to transition towards more flexible, customised and technology-driven plans by 2024-2025. However, buying adequate protection based on healthcare needs, life stage, and responsibilities will remain the prime consideration amidst these promising advances.