Thread by @chittukuruvi4

#healthinsurance #seniors #SeniorCitizens
@NandiniVenkate3 in her note, mentioned that being a Senior Citizen in India is scary. And I might add, "is tough as well". That tweet,

https://twitter.com/NandiniVenkate3/status/1437631393853370381?s=20

generated a lot of traction.
Let me try and address some part of it.

From a finance standpoint, There are 3 aspects of being a senior citizen: a. Health and Health Insurance Costs; b. A steady income from broad source of asset base. c. People who will put Vultures to shame and acting in the financial services industry space.

I will address the 1st part in this thread and why PM / must make an intervention.
Health Insurance to senior citizens is problematic. As they move into an age where they are faced with a prospect of reduced steady income, the demands on that money goes up.

Premiums in the industry - how it stacks up –
Average Premium across Insurance industry – on a Per Person Basis – between 55 to 60 and thereafter. For a Sum Insured of Rs. 5.00 Lakhs
Chart 1: Across selected Insurers of Indian General Insurance Companies.

Chart 2:
Disclaimer: Data collected from publicly available information.

Premium age band wise for selected companies.

1.The table represents an overly broad spectrum of plans / policies and premiums. It also does not consider the key qualitative aspects such as:
a.the kind of expenses that are covered
b.the options that are made available
c.factors such as No Claim Bonus etc.

d.Co-pay and specific exclusions, whether or not they cover pre-existing illness or otherwise
e.Arogya Sanjeevani Policies have not been considered..
f.The above table considers the plans that are open to all and do not touch “Senior Citizen” specific polices.

Sr. Citizens' policies have restrictive clauses in terms of :
a. Sum insured
b. Sub-limits – from Room Rent to specific medical treatments.
c. Co-pay – For Claims – varies from 20% to 30%
d. Premium Loading
Sr. Citizens' policy premium comparo: 👇👇

One can very well argue that the premiums for Senior Citizens is "loaded" against them because of Claims experience.
Let us see what the data says.

This data spread over a decade amply proves that it is the younger lot who are more susceptible to claims than the seniors. The only fact that is negative about the seniors is the ticket size. (This is not taking into account claims on account of Covid 19).
For 2008 or before

In terms of number of claims:

Data on claims for the year 2017-18

Which age group contributed what percent?

Age Band wise value of claims paid

The data is quite the contrary right??! That Senior Citizens' make up for huge claims in terms of numbers and quantum!! The only point where Senior Citizens score higher in claims is ticket size of the claim. Is it not unfair to load the Seniors with most premium??

The other thing that happens with Senior Citizens is the steep increase in premiums by Insurers:
When an Insurer replaced the existing product with another one, in one case, the premium went up as under –

i. For his father from Rs. 6390 to Rs.33927/- per year
ii. For his mother, the premium went from Rs. 6390 to Rs. 29812/-. (albeit, the sum insured also went up by a small measure).
Where he was paying under Rs. 13k per year, the premium went to Rs. 63k!!

Case # 2: Premium for a senior citizen went from Rs. 17k to Rs. 55K only. And this when the income especially during Covid time became NIL. Appeal to Finance Ministry, probably went to Black Hole.

In many cases, these steep increase come at a time when the Sr. Citizens can't even move to another company with the same conditions, as underwriting considerations come in.

And which Sr. citizen has the knowledge and / or time to compare premium. Forget comparison of premium, they even won't know the conditions and clauses. Caveat: This is applicable in major number of cases, there will always exceptions.

Possible Solution: Intervention by @PMOIndia @FinMinIndia by including Seniors at least from 65 onwards under Ayushman Bharat Yojana. Don't have to give it for free. Charge per head Rs. 7.5k to 10k and provide a cover ranging from Rs. 5.00 Lakhs to Rs. 10.00 Lakhs per person.

The above should cover OPD as well. Movement of senior citizens from the Insurance industry into the Ayushman Bharat will not necessarily mean that Insurers are losing. Rather the premium basket will undergo a change.

This could become a platform to provide a holistic approach to health care through a Health App something similar to CoWin App based on Unique Identification.
Will continue the thread #healthinsurance
cc: @CandidShweta @nsbchd @venkate98507511 @BanCheneProduct @CAVijayaSuresh

@CandidShweta @nsbchd @venkate98507511 @BanCheneProduct @CAVijayaSuresh The thread is not meant to be critical of Insurers but rather the tough situation the Sr. Citizens find themselves in.

cc: @wataboutery @BesuraTaansane @naikrakesh @UshaNirmala @NarayananPalakd and taking the liberty of tagging @anexcommie

Other reference tweets:

https://twitter.com/chittukuruvi4/status/1240279824444182528?s=20

https://twitter.com/chittukuruvi4/status/1332579082635153408?s=20

https://twitter.com/chittukuruvi4/status/1218214682793631744?s=20

https://twitter.com/chittukuruvi4/status/1331881240249569281?s=20

https://twitter.com/chittukuruvi4/status/1331490446858588162?s=20

https://twitter.com/chittukuruvi4/status/1335561843440451588?s=20

https://twitter.com/chittukuruvi4/status/1332579082635153408?s=20

https://twitter.com/chittukuruvi4/status/1372126025400811526?s=20