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Less Health Insurance Premiums for Those Keeping Themselves Fit?

Published On Nov 26, 2019, Updated On Feb 08, 2021

Healthcare expenses have shot up in the past few years. Which is why it becomes important to increase awareness for preventive healthcare. Preventive healthcare is keeping oneself fit, failure to which makes the person more prone to diseases, especially when he/she has a sedentary lifestyle. Even insurance providers give special importance to preventive healthcare by providing the policyholders several wellness and preventive benefits to promote fitness. In fact, if you are aged 40 or more and not keeping fit, you may have to pay a health insurance premium higher than others.    

IRDAI (Insurance Regulatory and Development Authority of India) has also recognised the need for preventive healthcare. The insurance regulator has drafted new guidelines with ‘discounts on premiums on keeping fit’ being the biggest takeaway. These guidelines are an extension of previous regulations which will offer more services to the policyholders and shall come into force with immediate effect.

The MD and CEO of Max Bupa Health Insurance Co. Ltd, Ashish Mehrotra says, “It has become important to prioritize health and include preventive healthcare measures in one’s daily life. With this move, we believe that health insurance will no longer be perceived just as a measure to secure oneself against unforeseen illnesses; rather it will become a part of one’s daily health needs.”

The Chief Operating Officer of Future Generali India Insurance Co. Ltd., Shreeraj Deshpande feels that the new guidelines complement the previous ones as they allow ways in which use of wellness features can be incentivised. Despande adds, “While the earlier guidelines introduced wellness as a feature in health insurance, there were no avenues of encouraging customers to actually use those features.”

Wellness perks

The insurance regulator IRDAI has proposed a few ways in which the insurers can provide wellness perks to the policyholders. On the basis of which, the insurers can offer vouchers to purchase protein supplements or other health supplements, vouchers for yoga center or gym memberships. Other discounts will continue as well including on OPD consulations, treatments, health check-ups in-network hospitals, etc. 

The Insurance Regulatory and Development Authority of India has also permitted the insurers to extend the list of benefits by offering cover for non-payable items in the treatments. The Executive VP of IFFCO Tokio General Insurance, Subrata Mondal says, “Insurers can vary the benefits offered on the basis of geography, product design and claims experience. Insurers could come up with customized health-risk assessment tools to help policyholders realize their fitness levels. The associated cost may vary from insurer to insurer based on the design of the wellness programme.”

Going by the draft

The insurance regulator IRDAI has asked the insurers not to promote third-party merchandise in their ads. Also, the insurers can’t accept any liability for the standard of products and services that a third party offers. However, they are allowed to disclose the products and services offered on their websites in detail.  

Insurers are given a job to ensure that every piece of information of a product is disseminated correctly by the service providers. And insurers are not allowed to pay to service providers or third party service apart from monetized value of reward points that the policyholders have redeemed. The insurance companies must disclose payouts for every product for every third party merchant in the yearly public disclosures.   

The insurers will have to disclose the way in which the accrual and redemption of benefits will be done for all the members. For all the products, whether accrued benefits can be carried forward at the time of policy renewal or not, needs to be clearly specified in the policy document.  

How will it benefit you?

As providing wellness features will increase the premium amount, the insurers would be willing to offer those to the customers. As these features will keep the policyholders motivated to follow a fitness regime, which will also reduce the claims ratio. 

Many insurers believe that there will be a pricing impact on insurance products. But access to preventive healthcare would become cheaper as insurance companies will source these services at an aggregate level on behalf of customers.  

The insurers will be incentivising the people to adopt a healthy lifestyle. It may also then have impact on having fewer chances of hospitalisation owing to lifestyle-related issues. As per the experts, following the guidelines will keep both insurers as well as policyholders happy.    

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