Considering the strenuous way of life, we all live today, staying covered under a comprehensive health insurance plan has become a pivotal need. Moreover, over the last couple of years, even the structure and features of health insurance plans in India have evolved to cater to the specific needs and requirements of the customers. Many people have now started to practice a healthy lifestyle that is backed up with efficient and effective wellness and preventive programmes. And with customers showing keen interest in becoming health and fitness conscious, it is important for insurers to come up with plans that focus on making customers fit and health.
Fortunately, the Insurance Regulatory and Development Authority of India has like always come out in support of the consumers and have issued guidelines on wellness and preventive features.
What the Guidelines Say
The regulatory body has directed all life, general and specialised health insurers to include features and benefits in their health insurance plans that drive policyholders towards maintaining a good health. As per the circular, the insurers have been suggested by the IRDAI to offer reward points to customers who follow and meet the set criteria of wellness and preventive features. Though, it is mandatory for the insurers to only offer such features after filing or incorporated them in the product in line with the product filing guidelines. It will be compulsory for the insurance companies to reveal the entire methodology and the criteria used for arriving at the reward points. For family floater plans, insurers shall need to clearly define and disclose to the policyholders the way in which accrual and redemption of rewards would be considered.
Most importantly, the wellness features that the insurer plans to offer may either be offered either as optional or as add-on covers to the policyholders. The issued guidelines are aimed at helping insurers focus on preventive aspects. With the introduction of such products, consumers will now be able to compare the various health insurance products not only on aspects like prices and extent of coverage but also on the wellness and preventive benefits that they offer. Further, the cost of implementing the wellness features will have to be factored into the pricing and costs of the insurance policies and shall be rightly disclosed to the policyholder in the prospectus.
Rewards for the Policyholders
The regulator has listed a plethora of exciting benefits that insurers may consider offering to the policyholders. Some of such benefits include discounted OPD consultations or treatments, Pharmaceuticals, Health check-ups/ diagnostics, redeemable vouchers to obtain health supplements, memberships in yoga centres, sports clubs and many more. Under the guidelines, the insurers are even allowed to translate wellness parameters into fitness challenges and engage customers to improve their health outcomes. Formats can be decided on various parameters that include steps taken, sleep patterns, weight tracking, diet regime, participation in marathons and many others.
For tech-savvy customers, insurers may even incorporate more advanced features like use of wearable products which can collect data throughout the day on activities of the customer and help the insurer better understand the specific health needs of the customer. This will help insurers offer their customers customised products that focus on specific disease management programmes or doctor consultation for a specific reason.
What Insurers Are Offering
Numerous prominent insurers like Max Bupa, Aditya Birla Capital, ICICI Lombard, Bajaj Allianz and ManipalCigna are already offering health insurance plans with wellness features that reward the customers for maintaining a good health. The policyholders are given rewards provided they participate in the wellness programme run by the insurers. Mostly, the rewards are in the form of points which customers can accumulate while completing various tasks say for instance running 3 km/day or walking 10,000 steps/day. The accumulated points can be later redeemed against availing services like outpatient consultation (OPD), pharmaceutical expenses, diagnostic services and health check-ups.
Renowned insurer Aditya Birla Capital runs a health plan under which customers can earn health returns (reward points) through accumulation of ‘Active Dayz’. A policyholder earns one Active Day by burning 300 calories in a day through different physical activities. Similarly, ICICI Lombard also operates an iHealth Plus insurance policy under which the policyholder earns 100 points to quit smoking. The policyholder can even earn up to 1,000 points by undergoing a medical check-up at one of the network hospitals. The accumulated points can be later redeemed against OPD, dental expenses etc. Under Bajaj Allianz General, you can redeem the accumulated points for co-pay waiver at the time of claim or enhance the sum insured in case of no claim.
(By Amit Chhabra, Head-Health Insurance, Policybazaar.com)