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? APOLLO DKV TO SCALE UP BIZ, NETWORK, LAUNCHES NEW HEALTH
I am proud to release the Fourth
edition of Health Shield and
INSURANCE PLAN
would like to congratulate
Health Shield team for their
dedicated efforts. Apollo DKV, India’s second stand alone health insurer and a joint venture of Apollo Hospitals group
and DKV AG, Europe’s largest health insurer, has drawn up plans to scale up its business and the
Last month we conducted the network of offices in the next couple of years to garner a good share of the growing market for health
MDP on “TPA, Under‐writing,
insurance.
Actuarial & IT Aspects of Health
Insurance” on 7th & 8th of
November. We would like to Company chief executive officer, Antony Jacob said in Chennai on Wednesday that against 24 offices
welcome you at our coming now, it would have 30 by March end. Its premium income has now touched Rs 70 crore from Rs 49
MDP on Micro Health Insurance. crore in 2009‐10 and hopes to close this year with Rs 105 crore. Next year, it plans to add 12 offices and
achieve a premium income of over Rs 200 crore. By 2012‐13, the JV’s plan is to have 55 offices with a
We once again thank you for premium income of Rs 700 crore and agents of 40,000 (10,000). Stating that its present capital of Rs
your letters of appreciation and
220 crore is adequate to support the growth plan, Mr Jacob said that it is looking at doubling it after a
the kind support you all have
couple of years. Its employee’s strength is to touch 1600 by 2012‐13 from the current 432.
extended to us.
Prof. Harish Sihare Speaking to mediapersons on the occasion of launching a new 360 degree health plan — Maxima, the
harish@iihmrdelhi.org CEO said that Indian health insurance market grew from Rs 500 crore 11 years ago to the current Rs
9911948406 10,000 crore. In the last three years, the health insurance market has been growing at a CAGR of over
45 per cent and it is expected to clock 50 per cent growth per annum in the next five to seven years.
The venture, which has rolled out first generation products, sees tremendous scope to become a
ANNOUNCEMENT significant player in the segment. The products are valid in all the hospitals across the country on a
reimbursement basis. Its policy holders can avail cashless hospitalisation service in around 4000
MDP @
designated hospitals, including 42 Apollo group hospitals. It will leverage on the backing by India’s
largest integrated healthcare group in partnership with Europe’s No I pure health insurance company
Health
Mr Jacob said the venture will go in for bankassurance model for forging tie ups with banks for selling
Insurance the products once the existing rules (which restricted the tie up to one life insurer and one non‐life
insurer) are relaxed. Besides the agency force, it is using exclusive tie ups with NBFCs, database
marketing, internet etc, for distributing the products. He said that the company has started
developing co‐insurance products and the first one was launched in August this year in tie up with
HDFC alliance. Under such initiatives Apollo DKV would design the product while the marketing would
be done by the partner. It will also look at partnering with state governments to cover a large number
of weaker sections. It has signed a MoU with Meghalaya government for an insurance scheme (RSY)
and is expected to be rolled out next month. He claimed that Maxima is India’s first 360 degree health
plan which is set to redefine health insurance in the country. Initially, it will be available in the four
metros and Bangalore and Hyderabad. It has special features like life long renewal benefit, annual
comprehensive health check up, Rs 3 lakh cover for IP treatment with pre and post hospitalization
“MICRO HEALTH benefits, Income tax benefit and cumulative bonus and carry forward of OPD benefits.
INSURANCE
Innovative products
and marketing ? ON THE BAFFLING PUSH TO PROHIBIT ILLEGAL IMMIGRANTS FROM
strategies for Indian BUYING INSURANCE
Healthcare setup.” It’s tough to find any justification — outside of political pandering — for the decision by Senate
Democrats to prohibit illegal immigrants from buying health coverage on the insurance exchanges
Date: 16 & 17th April, 2010
th proposed under their health reform bill. Sure, it makes those lawmakers appear tough on illegal
immigrants. But no one on either side of the aisle has been able to demonstrate how allowing those
folks to buy insurance from private companies at full price would threaten the well‐being of the
For details contact nation. In fact, such a prohibition would have the likely consequence of forcing illegal immigrants into
emergency rooms rather than encouraging them to get preventive care — an expensive trend for
Prof. Harish Sihare taxpayers, and one that’s been among the chief complaints of those condemning the societal
harish@iihmrdelhi.org “burdens” posed by illegal immigrants.
+91‐9911948406
EVENTS @ IIHMR ? LIFE INSURANCE INDUSTRY TO CLOCK RS. 2,55,000 CR PREMIUM
THIS FISCAL
International Workshop on
Environmental Sanitation
The Indian life insurance industry is expected to grow by about 15 per cent in the current financial
& year to touch a total premium income of Rs 2,55,000 crore .Despite the slowdown in the economy,
Health Management life insurance industry has continued to grow as policyholders are realising the value of insurance.
We continue to be optimistic about the future of the insurance business in India and expect the
January 18-22, 2010
industry to grow approximately at 15 per cent," Life Insurance Council Secretary General S B Mathur
@ said in a statement. As per the industry body's estimates, the target for total premium at Rs 2,55,000
IIHMR, New Delhi crore for this fiscal would be achieved, he added. The industry had garnered Rs 2,21,688 crore of
For more details logon to total premium in 2008‐09, the statement said. In the first six months of this fiscal, the insurance
www.iihmr.edu.in industry has already mopped up Rs 1,01,976 crore of premium registering a growth of 18 per cent
over the year‐ago period. As per the industry body, total renewal premiums for regular Unit Linked
Insurance Plans (ULIPs) witnessed a growth of 40 per cent in April‐September period at Rs 25,950
crore compared with Rs 18,506 crore in the same period last fiscal. New business premium increased
by 13 per cent to Rs 38985 crore from Rs 34,529 crore for the corresponding period in 2008‐09, it
said. In the first half, total benefit paid to policyholders stood at Rs 28,373 crore as against Rs 23,070
crore, up 23 per cent, the council said.
? INDIAN INSURANCE SECTOR: A RECORD ACHIEVEMENT BY ICICI
The number of individuals insured under Rajiv Gandhi Shilpi Swasthya Bima Yojana (RGSSBY) ‐ the
first ever 'cashless' health insurance initiative for Artisans in India ‐ crossed 19 lacs as on September
30, 2009.
An online web based course of
Artisans spread over 29 states and 608 districts benefit from this comprehensive health insurance
Certificate in Project
scheme facilitated by the Development Commissioner‐ Handicrafts under the Ministry of Textiles. All
Management (CIPM) – Artisans (men and women) up to the age of 80 years are eligible for coverage. Under this innovative
government sponsored health insurance scheme the Artisan, spouse and two dependents are
specialization in Healthcare.
covered annually for hospitalization expenses up to Rs.15,000. The principal member Artisan is also
covered for Rs 1 lakh due to personal accident.
For Registration and other details
logon to For the first time in the country a health insurance scheme is giving access to cashless treatment for
www.cepm‐iihmr.org OPD (outpatient) treatment. The network of 860 OPD centres includes selected clinics that provide
day‐to‐day treatment on a cashless basis to the Artisans including alternative therapies such as
Unani, Ayurveda, Homeopathy and Siddha. The insured Artisans can also get access to cashless
hospitalization in over 2,683 network hospitals across urban and rural India. Nearly 6 lakh policy
holders this year availed of RGSSBY's unique 'cashless' facility.
The RGSSBY health scheme is underwritten by ICICI Lombard General Insurance and covers
comprehensive pre and post‐hospitalization expenses for the Artisan, his/her spouse and two
children/dependants/parents. The medical expenses cover pre‐existing diseases, new ailments,
maternity benefits, dental treatment, eye treatment, spectacles, domiciliary hospitalization and
alternative therapies like Ayurvedic, Unani, Homeopathic and Siddha. Artisans are also entitled to
personal accident coverage for themselves.
MDP @ IIHMR
? SENATORS STRIKE HEALTH DEAL
Micro Health Insurance
“Innovative products and Senior Senate Democrats reached tentative agreement Tuesday night to abandon the government‐
marketing strategies for run insurance plan in their health‐overhaul bill and to expand Medicare coverage to some people
Indian Healthcare setup” ages 55 to 64, clearing the most significant hurdle so far in getting a bill that can pass Congress.
Senate Majority Leader Harry Reid (D., Nev.) had advanced a bill that would have had the
government directly operate a health‐insurance plan, while giving states the right to opt out.
Date: 16th & 17th April, 2010
In place of that, the senators embraced a more limited proposal that would empower the
Faculty @ MDP government's Office of Personnel Management to put in place a new low‐cost national health plan,
congressional aides said. The office already administers plans offered to federal employees and
members of Congress. The new national plan would be run by nonprofit entities set up by the private
Mr Rajgopal Rudraraju sector, and would be available to the public on the new insurance exchanges that would be created
Chief Manager Health Mgmt. under the bill.
Apollo DKV
If no private insurers sign up with the Office of Personnel Management to offer a national plan, the
Prof. Harish Sihare office would be authorized to implement a direct government‐run plan, an unlikely prospect, aides
said. In a nod to Democratic liberals still intent on expanding coverage, the group agreed to a
Faculty,
proposal that would open Medicare, the health‐insurance program for the elderly, to Americans ages
IIHMR, New Delhi 55 to 64. The proposal would benefit an estimated two million to three million Americans who have
difficulty obtaining coverage elsewhere, including those who have lost their jobs. People in the 55‐to‐
Dr. G Gandhi 64 group who already get health insurance through their employers would continue to do so under
Senior Consultant, ILO the proposal.
Those eligible under the expanded Medicare program would be allowed to buy into it at subsidized
Mr. Rohit Kumar rates, but would likely pay more than retirees age 65 and over. Although the public option generated
Regional Manager, Provider significant dissension among Democrats, the CBO projected that a relatively small number of
Management Americans would use it. It said total enrollment after a decade would be only three million to four
ICICI Lombard million people, in part because the CBO predicted the public option would attract less‐healthy
employees and charge higher premiums.
? CUSTOM HEALTH PLANS REVAMPS WEB SITE AND LAUNCHES BLOG
TO HELP CONSUMERS FIND THE BEST OPTIONS FOR AFFORDABLE
HEALTH INSURANCE
Today Custom Health Plans, the one‐stop‐shop for Texas health insurance, announced
EMINENT the launch of its new Web site and Blog aimed to alleviate Americans’ unanswered
SPEAKERS questions and feelings of confusion regarding health insurance and health care reform.
@ The Custom Health Plans Web site advocates consumer choice by aggregating health
plan information from top tier Texas health insurance companies, allowing consumers
IIHMR Delhi to choose which plans and prices best fit their needs and budgets. The site provides a
HEALTH step‐by‐step guide that assists consumers in researching, shopping, comparing and
CONCLAVE buying health insurance policies, and offers useful information regarding short term
health plans, individual and family plans and health savings accounts.
Dr. Kevin Fickenscher, Executive
Vice President,
Custom Health Plans’ new Blog, the Texas Health Insurance Guide, provides
Perot Systems Corporation, U.S.A.
informative content and a fresh perspective about the most current healthcare‐related
Dr. Shiban Ganju, news, especially relevant during this time of health care reform.
Chairman, Atrimed, U.S.A
“In a current healthcare climate marred by confusion, Custom Health Plans aims to
help individuals, families, small business owners and the self‐employed navigate the
Lt. Gen (Dr.) J. R. Bhardwaj,
PVSM, AVSM, VSM, PHS (Retd.) maze of health insurance options,” said Richard Monello, President/CEO of Custom
Member, National Disaster Management Health Plans. “Our simple, easy‐to‐use platform allows consumers to make informed
Authority decisions in their search for affordable health insurance, while receiving personalized
Government of India service and guidance every step of the way.”
Mr. Nicholas G Middleton,
President, APAC & Global Growth,
Simpler Consulting, UK ? INSURERS UNDER FIRE FOR DENIALS OF CARE, INADEQUATE
COVERAGE
Dr Captain (Retd) Mozibur Rahman
Fakir
State Minister for Health & Family Forbes reports on a "recent federal lawsuit filed in Mississippi against the local Blue
Welfare, Bangladesh - Cross & Blue Shield and the Electric Power Association's benefits plan. ... The lawsuit
"Revitalization of Community Health provides a window into the chaos created by America's piecemeal insurance market.
Care System of Bangladesh". Workers face an ever‐shifting array of health benefits that change each year at open
enrollment time as employers shop around for better deals. What's covered in 2008
Mr. Girdhar J. Gyani suddenly may not be in 2009." The case involves plaintiff Paige Riley, 42, who has a
Secretary General, painful stomach condition called gastroparesis and "alleges that Blue Cross & Blue
Quality Council of India Shield of Mississippi refused to cover an operation to replace the batteries of a
stomach‐pain device she had surgically implanted in 2005. As a result, Riley had to fork
Dr. A. K. Shiv Kumar over the $43,364.27 cost in cash." Forbes notes that the insurer denied care, saying the
Member, NAC & Adviser, device was experimental, and adds "the lawsuit has relevance to the current debate in
UNICEF Washington. ... 'This shows that with health reform it will be important that those who
are insured still have strong appeal rights,' says [Jennifer] Jaff, [a] patient advocate."
Dr. Beulah Shekhar Blue Cross & Blue Shield of Mississippi had no comment on the suit (Whelan, 11/23).
National General Secretary,
YWCA of India Meanwhile, The Baltimore Sun has consumer advice about medical debt, which is "the
single largest contributor to people declaring bankruptcy," examining what states
have done to protect people and answering questions on how to avoid medical debt.
"It's not just uninsured patients who rack up steep medical bills. Even if you have
insurance, you might not realize that your coverage is inadequate until you're sick and
overwhelmed by co‐payments and other health costs." Maryland started a law in June
to protect patients: "The law now requires hospitals here to provide free or reduced‐
price care to low‐income residents and to give patients information about financial
assistance.
The Newsletter is open for inclusion of any information or advertisement; however
selection of information will be governed by the HEALTH SHIELD TEAM, IIHMR‐NEW
DELHI‐110075
IF YOU DO NOT WISH TO RECEIVE FURTHER ISSUE, KINDLY MAIL US.
Date & Venue
For Restricted Private circulation only
18th & 19th February, 2010
Inaugural
session
@
Conclave
Release of
Souvenir
book
Session under
progress
COMPILED
BY
The Health Shield Team,
PGDHHM
IIHMR, NEW DELHI
www.iihmrdelhi.org Secretary
General, QCI
Mr.Girdhar Gyani
with President
Lal Path Labs
Mr. Arvind Lal
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