Coronavirus could change how health insurance works

Disruption may lead to new products like OPD insurance, claims platforms, and gamification of premium pricing

Published: 02nd November 2020 08:13 AM  |   Last Updated: 02nd November 2020 08:13 AM   |  A+A-

Image used for representational purpose only (Express Illustration | Tapas Ranjan)

Express News Service

The global pandemic and lockdowns imposed in most countries have disrupted lives for people in many ways. Your health is no exception. You are grounded at home due to lockdowns, and physical activity is minimal. The way you adapt to this disruption would change the way we look at healthcare forever. 

About 85 per cent of medical practitioners in India used teleconsultation during the lockdown. More than 80 per cent of these teleconsultations were from first-time users and a good 44 per cent from non-metro towns. That was revealed in a survey conducted by Boston Consulting Group or BCG, a global consulting firm for Federation of Indian Chambers of Commerce and Industries (FICCI) last month.

The government’s proposed National Digital Health Mission could transform the way your healthcare eco-system functions. There are very few people who have never had problems with their insurance claims. There are too many stakeholders: hospitals, insurance companies, third-party agents, and you, the policyholder. Rest assured that it is not easy on the hospital as well as the insurance company. The paperwork is cumbersome for you, the hospital, as well as the insurance company.

The government plan envisages creating a digital claim processing system, according to the National Health Mission Blueprint. According to the FICCI-BCG analysis, it could unlock value not just for the hospitals and insurance companies but also for you as a policyholder. The mission envisages a national health identification number that would allow hospitals, insurance companies and agents to track your records. Data would effectively enable insurance companies to reduce health insurance premiums for those who lead a healthy life.

A technology stack similar to the United Payment Interface or UPI system in financial services that you already use. There could new products like OPD insurance and ‘gamifying’ premium pricing linked to your behaviour.There could be common health claim platforms that could validate your request for a claim by routing it to relevant stakeholders, guarantee payments to you and collect the necessary information. All of that can be done through e-claims, e-discharge forms, etc.

What this means for you
The digital transformation in the insurance sector could mean you could get personalised insurance. For example, you could, in the future, enroll for gamifying your premium. Your health tracker will align with your insurance company. There is a good chance that your insurance company could provide you with one since it suits them. You could get rewarded for following healthy living habits. Based on the points you earned, you could get benefits from the insurance company. You can exchange these points for rewards from the eco-system. 

The importance of maintaining a healthy lifestyle keeps related diseases away. If you read any healthcare literature online, you will know that in India, nearly 50 per cent of deaths occur due to lifestyle-related illnesses. If you maintain your lifestyle, it should help insurers to keep your policy simple and the health insurance premium reasonable. 

Your agility matters
Besides physical agility, you need to be technologically agile too. A real worry is over the use of personal data. If you are using digital banking, and have an active social media presence, you are already giving out a lot of information. If assurances from banks, payment companies, online food ordering firms and social media companies are good enough, then so should such assurances from the National Digital Health Mission.

Amidst the pandemic, over 16 crore people have already given valuable health-related information to the government by using the ‘Arogya Setu’ application. A lot of you have managed to make the first digital banking transaction or even a stock market trade on your smartphone. Many of you have already found out the ease with which you can make small payments from your phone. All of that is a massive leap already. Technology has to be an enabler to better healthcare.

While we await the introduction of the new healthcare system, we have also to take care of the situation at hand. The pandemic is a wake-up call for those who do not prioritise healthcare. The money you save needs to be protected too. You need to take up appropriate insurance and save adequate funds to protect yourself and your loved ones.

(The author is editor-in-chief at


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