Samiran
 kundu
  A-06
   Health insurance is insurance against the risk of
    incurring medical expenses among individuals.
   A contract between an insurance provider and an
    individual or his sponsor
   The contract can be renewable or lifelong in the
    case of private insurance, or be mandatory for all
    citizens in the case of national plans.
   The type and amount of health care costs that
    will be covered by the health insurance provider
    are specified in writing, in a member contract or
    "Evidence of Coverage" booklet for private
    insurance, or in a national health policy for public
    insurance
   In the late 19th century, "accident insurance"
    began to be available, which operated much
    like modern disability insurance.
   Accident insurance was first offered in the
    United States by the Franklin Health
    Assurance Company of Massachusetts. This
    firm, founded in 1850.
   Health insurance, as we know it today, was
    introduced only in 1912 when the first
    Insurance Act was passed.
   The penetration of health insurance in India
    has been low. It is estimated that only about
    3% to 5% of Indians are covered under any
    form of health insurance.
   In terms of the market share, the size of the
    commercial insurance is barely 1% of the total
    health spending in the country.
   Health insurance is one of the fastest growing
    areas in the insurance industry with annual
    growth rate of 25%.
    Health Premium has risen to Rs. 11000
    crores in 2010-2011.
    As per the recent reports from various
    agencies the health sector has the potential
    to become a Rs. 30000-crore industry by
    2015.
According to World Bank Report
 1 in 3 Person
  Will develop some life threatening cancer.
 1 in 4 Person
  Will contact heart disease before they retire.
 1 in 20 Person
  Risk the chance of having stroke before the
  age of seventy
   85 % of the working population in India DO
    NOT have Rs. 5,00,000 as instant cash.
    14 % have Rs. 5,00,000 instantly BUT will
    subsequently will face a financial crunch
   Only 1% can afford to spend Rs. 5,00,000
    instantly and easily.
    99 % of Indians will face financial crunch in
    case of any critical illness.
   Let us look at what it costs in a good/ reputed
    hospital for treatment of
   Angioplasty Rs. 2,00,000 to Rs. 3,00,000
    Open heart surgery Rs. 2,50,000 to Rs. 4,50,000
    Liver Transplant Rs. 30,00,000
   Kidney Transplant Rs. 18,00,000 to Rs.
    30,00,000
   Hernia surgery Rs. 30,000 to Rs. 60,000
    Cancer-Chemotherapy - Rs. 7000 to Rs. 10000
    per visit and number of visits may be 4 to 20
    means that cost can be as high as Rs. 2,40,000.
    It is only that Health insurance policy taken by a
    person can take care of hospitalization costs of
    this magnitude.
   Premium: The amount the policy-holder or
    his sponsor (e.g. an employer) pays to the
    health plan to purchase health coverage.
   Deductible: The amount that the insured
    must pay out-of-pocket before the health
    insurer pays its share.
   Co-payment: The amount that the insured
    person must pay out of pocket before the
    health insurer pays for a particular visit or
    service.
   Coinsurance: Instead of, or in addition to, paying
    a fixed amount up front (a co-payment), the co-
    insurance is a percentage of the total cost that
    insured person may also pay.
   Exclusions: Not all services are covered. The
    insured are generally expected to pay the full
    cost of non-covered services out of their own
    pockets.
   Coverage limits: Some health insurance policies
    only pay for health care up to a certain dollar
    amount.
   Out-of-pocket maximums: Similar to
    coverage limits, except that in this case, the
    insured person's payment obligation ends
    when they reach the out-of-pocket
    maximum, and health insurance pays all
    further covered costs.
   Capitation: An amount paid by an insurer to a
    health care provider, for which the provider
    agrees to treat all members of the insurer.
   Apollo Munich Insurance Company Limited
   Bajaj Allianz General Insurance Co. Ltd.
   Bharti AXA General Insurance Co. Ltd.
   Cholamandalam MS General Insurance Co. Ltd.
   Future Generali India Insurance Co. Ltd.
   HDFC ERGO General Insurance Co. Ltd.
   ICICI Lombard General Insurance Co. Ltd.
   IFFCO Tokio General Insurance Co. Ltd.
   Larson & Toubro General Insurance Co. Ltd.
   Max Bupa Health Insurance Co. Ltd.
   National Insurance Co.Ltd.
   New India Assurance Co. Ltd.
   Oriental Insurance Co. Ltd.
   Raheja QBE General Insurance Co. Limited
   Reliance General Insurance Co. Ltd.
   Royal Sundaram Alliance Insurance Co. Ltd
   SBI General Insurance Co. Ltd.
   Shriram General Insurance Co. Ltd.
   Star Health and Allied Insurance Company Limited
   Tata AIG General Insurance Co. Ltd.
   United India Insurance Co. Ltd.
   Universal Sompo General Insurance Co. Ltd.
   Health Insurance Covers hospitalization when
    a patient is in hospital for more than 24
    hours due to:
    Illness
   Accident
   Surgery requirement
   Symptoms, when diagnosis is been done, the
    costs covered are
   Room, Boarding Expenses in Hospital/Nursing
    Home
   Nursing Expenses, intensive care unit expenses,
   Surgeon, Anesthetist, Medical
    Practitioner, Consultants, Specialist fees
   Anesthesia
   Pre-Hospitalization Expenses
    Post-Hospitalization Expenses
   General Health and Eye Examination (Optional
    with extra premium)
    Local Ambulance Services (Optional with extra
    premium)
    Hospital Daily Allowance (Optional with extra
    premium)
   Treatment of illness at home by consulting
    doctor in your locality
   All diseases /injuries which are pre-existing
    when the cover incepts for the first time.
   Any disease other than those stated in the in
    clause contracted by the Insured Person during
    the first 30 days from the commencement date
    of the Policy.
   Injury or Disease directly or indirectly caused by
    or arising from or attributable to
    War, Invasion, Act of Foreign Enemy, Warlike
    operation (whether war be declared or not).
   MONEY SPINNERS IN HEALTH INSURANCE.
   If David Beckham
    ever stops being
    able to "bend it," his
    posh lifestyle will go
    on. His magic legs
    are insured for a
    cool $70 million
NFL player Troy
Polamalu is famous
for more than his
moves on the field
Bruce Springsteen
knows his voice is a
hot commodity. The
Boss' pipes are
insured for $5
million.
Rolling Stone Keith
Richards has his
middle finger
insured for $1.6
million in case he
ceases to be able to
flip people off ... or
play the guitar.
“If anything happened to my assets, I’d be out
for a few months and I’d probably be out a
million dollars,” “I thought I’d cover my
assets… They’re my primary money makers.”
THANK YOU

Health insurance

  • 1.
  • 2.
    Health insurance is insurance against the risk of incurring medical expenses among individuals.  A contract between an insurance provider and an individual or his sponsor  The contract can be renewable or lifelong in the case of private insurance, or be mandatory for all citizens in the case of national plans.  The type and amount of health care costs that will be covered by the health insurance provider are specified in writing, in a member contract or "Evidence of Coverage" booklet for private insurance, or in a national health policy for public insurance
  • 3.
    In the late 19th century, "accident insurance" began to be available, which operated much like modern disability insurance.  Accident insurance was first offered in the United States by the Franklin Health Assurance Company of Massachusetts. This firm, founded in 1850.
  • 4.
    Health insurance, as we know it today, was introduced only in 1912 when the first Insurance Act was passed.  The penetration of health insurance in India has been low. It is estimated that only about 3% to 5% of Indians are covered under any form of health insurance.  In terms of the market share, the size of the commercial insurance is barely 1% of the total health spending in the country.
  • 5.
    Health insurance is one of the fastest growing areas in the insurance industry with annual growth rate of 25%.  Health Premium has risen to Rs. 11000 crores in 2010-2011.  As per the recent reports from various agencies the health sector has the potential to become a Rs. 30000-crore industry by 2015.
  • 6.
    According to WorldBank Report  1 in 3 Person Will develop some life threatening cancer.  1 in 4 Person Will contact heart disease before they retire.  1 in 20 Person Risk the chance of having stroke before the age of seventy
  • 7.
    85 % of the working population in India DO NOT have Rs. 5,00,000 as instant cash.  14 % have Rs. 5,00,000 instantly BUT will subsequently will face a financial crunch  Only 1% can afford to spend Rs. 5,00,000 instantly and easily.  99 % of Indians will face financial crunch in case of any critical illness.
  • 8.
    Let us look at what it costs in a good/ reputed hospital for treatment of  Angioplasty Rs. 2,00,000 to Rs. 3,00,000  Open heart surgery Rs. 2,50,000 to Rs. 4,50,000  Liver Transplant Rs. 30,00,000  Kidney Transplant Rs. 18,00,000 to Rs. 30,00,000  Hernia surgery Rs. 30,000 to Rs. 60,000  Cancer-Chemotherapy - Rs. 7000 to Rs. 10000 per visit and number of visits may be 4 to 20 means that cost can be as high as Rs. 2,40,000. It is only that Health insurance policy taken by a person can take care of hospitalization costs of this magnitude.
  • 9.
    Premium: The amount the policy-holder or his sponsor (e.g. an employer) pays to the health plan to purchase health coverage.  Deductible: The amount that the insured must pay out-of-pocket before the health insurer pays its share.  Co-payment: The amount that the insured person must pay out of pocket before the health insurer pays for a particular visit or service.
  • 10.
    Coinsurance: Instead of, or in addition to, paying a fixed amount up front (a co-payment), the co- insurance is a percentage of the total cost that insured person may also pay.  Exclusions: Not all services are covered. The insured are generally expected to pay the full cost of non-covered services out of their own pockets.  Coverage limits: Some health insurance policies only pay for health care up to a certain dollar amount.
  • 11.
    Out-of-pocket maximums: Similar to coverage limits, except that in this case, the insured person's payment obligation ends when they reach the out-of-pocket maximum, and health insurance pays all further covered costs.  Capitation: An amount paid by an insurer to a health care provider, for which the provider agrees to treat all members of the insurer.
  • 12.
    Apollo Munich Insurance Company Limited  Bajaj Allianz General Insurance Co. Ltd.  Bharti AXA General Insurance Co. Ltd.  Cholamandalam MS General Insurance Co. Ltd.  Future Generali India Insurance Co. Ltd.  HDFC ERGO General Insurance Co. Ltd.  ICICI Lombard General Insurance Co. Ltd.  IFFCO Tokio General Insurance Co. Ltd.  Larson & Toubro General Insurance Co. Ltd.  Max Bupa Health Insurance Co. Ltd.  National Insurance Co.Ltd.  New India Assurance Co. Ltd.  Oriental Insurance Co. Ltd.  Raheja QBE General Insurance Co. Limited  Reliance General Insurance Co. Ltd.  Royal Sundaram Alliance Insurance Co. Ltd  SBI General Insurance Co. Ltd.  Shriram General Insurance Co. Ltd.  Star Health and Allied Insurance Company Limited  Tata AIG General Insurance Co. Ltd.  United India Insurance Co. Ltd.  Universal Sompo General Insurance Co. Ltd.
  • 13.
    Health Insurance Covers hospitalization when a patient is in hospital for more than 24 hours due to:  Illness  Accident  Surgery requirement  Symptoms, when diagnosis is been done, the costs covered are
  • 14.
    Room, Boarding Expenses in Hospital/Nursing Home  Nursing Expenses, intensive care unit expenses,  Surgeon, Anesthetist, Medical Practitioner, Consultants, Specialist fees  Anesthesia  Pre-Hospitalization Expenses  Post-Hospitalization Expenses  General Health and Eye Examination (Optional with extra premium)  Local Ambulance Services (Optional with extra premium)  Hospital Daily Allowance (Optional with extra premium)
  • 15.
    Treatment of illness at home by consulting doctor in your locality  All diseases /injuries which are pre-existing when the cover incepts for the first time.  Any disease other than those stated in the in clause contracted by the Insured Person during the first 30 days from the commencement date of the Policy.  Injury or Disease directly or indirectly caused by or arising from or attributable to War, Invasion, Act of Foreign Enemy, Warlike operation (whether war be declared or not).
  • 16.
    MONEY SPINNERS IN HEALTH INSURANCE.
  • 17.
    If David Beckham ever stops being able to "bend it," his posh lifestyle will go on. His magic legs are insured for a cool $70 million
  • 18.
    NFL player Troy Polamaluis famous for more than his moves on the field
  • 19.
    Bruce Springsteen knows hisvoice is a hot commodity. The Boss' pipes are insured for $5 million.
  • 20.
    Rolling Stone Keith Richardshas his middle finger insured for $1.6 million in case he ceases to be able to flip people off ... or play the guitar.
  • 21.
    “If anything happenedto my assets, I’d be out for a few months and I’d probably be out a million dollars,” “I thought I’d cover my assets… They’re my primary money makers.”
  • 22.