Munish Daga, CEO, Remedinet Technologies, expounds on the scope and possibilities of digital platforms for healthcare insurance in India. This article was first published in the January edition of Express Healthcare.
Despite the technological evolution of the healthcare sector over the past two decades, health insurance in India continues to grapple with the same difficulties such as lack of adoption and complex utilisation. As a result, the adoption numbers struggle to make it past a disappointing percentage figure in a country with the second largest population in the world. On the flip side, the situation in which the health insurance industry currently finds itself, also presents tremendous opportunities to evolve, possibility to scale, and scope to become profitable. The emergency of the situation, in several cases has not only served as a business opportunity, but also led to the adoption of digital frameworks as foundational pillars that ensure last mile delivery of health insurance for the policyholder.
This article first appeared on Moneycontrol.com.
An unforeseen medical emergency can mean an unexpected financial burden apart from the emotional stress that such an incident entails. To ensure that adequate financial resources are at our disposal during such emergencies, we sign up for a health insurance policy. However, while this measure affords us some peace of mind, the family of the patient is still required to fill in a plethora of forms and furnish initial amount at the time of hospitalization. Though this amount can be claimed later from the insurance companies, arranging the required some at such an hour could be quiet challenging, especially if the procedures are long and complicated. Cashless health insurance policies are designed specifically to relieve stress for the insured at the crucial moment of hospitalization.
Cashless health insurance
Cashless health insurance is a policy where the health insurance companies settle the hospitalization and treatment bills directly with the hospitals without the immediate involvement of the insured. Under cashless health insurance scheme, Third-Party Administrators (TPAs) act as the bridge between the insurance companies and the hospitals. All the medical bills raised by hospitals are sent across to TPAs who then coordinate with the insurance companies to settle the claim. This process eliminates the need to furnish any amount at the time of hospitalization and also minimizes documentation required to avail medical services.
Cashless mediclaim service can be of two types:
- Planned claim – When the insured is aware of the hospitalization in advance
- Emergency claim – When immediate hospitalization is required due to serious illness or an accident