IRDA committee to look into health insurance for senior citizens

28 May 2007


Chennai: With insurers having turned positively unfriendly towards senior citizens by drastically hiking the premium rates, refusing insurance cover, inordinate delay in claims settlement, among others, the Insurance Regulatory and Development Authority (IRDA) has formed a committee under the chairmanship of K S Sastry, former chairman, National Housing Bank, to study how insurance companies could meet the need of senior citizens. (See: A bitter pill for senior citizens from National Insurance)

According to IRDA, health insurance for senior citizens requires a careful study by all stakeholders involved, the regulator, the government, the insurance industry, the medical service provider, the third party administrators and others.

The other members of the committee are:

  • V Hariharan, former president, Sundaram Fasteners Limited
  • A N Sood, president, Delhi Federation of Association of Senior Citizens,
  • Sri K.N.Bandari, secretary general, General Insurance Council of India and
    former CMD of The New India Assurance Co Ltd
  • B D Banerjee, former CMD of The Oriental Insurance Co Ltd and former
    Insurance Ombudsman, Mumbai
  • C Chandrasekhar, chief marketing officer, Apollo DKV Insurance Co Ltd and
  • Nimish R.Parekh, CEO, Parekh Health Management (Pvt.) Ltd

The committee''s terms of reference are:

  • Suggest commercially viable health insurance schemes for the senior citizens, while ensuring that these do not spiral into a high-cost healthcare system.
  • Identify the problems in extending health insurance to senior citizens without age limit and at affordable cost and suggest possible solutions.
  • Examine the pros and cons of separate health insurance schemes for the senior citizens considering the profitability and claim ratios of different segments of health insurance.
  • Examine the issues connected with "portability" of health insurance by the senior citizens from one scheme to another and from one insurer to another and suggest the manner and conditions in which such portability is achieved.
  • Examine the feasibility of offering a menu of options to the senior citizens in terms of the type of diseases (including "pre-existing diseases") to be covered, the proportion of expenses to be paid, and the quantum of "deductible".
  • Suggest streamlining of procedures such that medical treatment is on "cashless" basis and is rendered promptly.
  • Suggest ways to incorporating alternative systems of medicine into the health insurance system.
  • Suggest possible incentives to the senior citizens for adopting healthier life styles.
  • Examine the feasibility of incorporating the concept of "family doctor" into the health insurance schemes for the senior citizens.
  • Examine the feasibility of integrating travel insurance such as "Overseas Mediclaim" policy into the health insurance schemes of senior citizens.

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