IN 2015-16, the health insurance segment achieved a growth rate of 21.7 per cent in gross premium, the highest in the past five years grossing a premium of Rs.24,448 crore (Rs.20,096 crore in the previous financial year).
The four public sector general insurance companies continued to account for a major share at 64 per cent of total health premium.
Standalone health insurers contributed 16 per cent of total health insurance premium, registering an increase of two per cent over the previous year. However, there is a drop in the share of private general insurers, whose market share has come down from 22 per cent in 2014-15 to 20 per cent in 2015-16.
Standalone health insurers registered a growth rate of 41.12 per cent (31.07 per cent) and the specialised insurers registered a growth rate of 18.04 per cent (12.7 per cent)
The underwriting losses of standalone health insurers decreased to Rs.273 crore in 2015-16 from Rs.611 crore in 2014-15.
During 2015-16, the general and health insurance companies issued around 1.18 crore health insurance policies covering 35.90 crore persons (28.8 crore people in 2014-15), registering a growth of 24.65 per cent over the previous year.
In terms of number of persons covered under health insurance, three-fourth of the persons were covered under government sponsored health insurance schemes and the balance one-fourth were covered by group and individual policies issued by general and health insurers.
Health insurance business is classified into government-sponsored health insurance, group health insurance (other than government sponsored) and individual health insurance. Among these three classes of business, individual health insurance business has reported noticeable increase in its share in total health insurance premium over the past five years, increasing from 37 per cent in 2011-12 to 42 per cent in 2015-16.
Five states namely Maharashtra, Tamil Nadu, Karnataka, Delhi UT and Gujarat, contributed 69 per cent of the total health insurance premium. Maharashtra alone contributed Rs.7715 crore (32 per cent) of total health insurance premium.
Channel wise distribution
Among the various channels of distribution, individual agents continue to contribute a major share of total health insurance premium at 33 per cent. Their share in individual health insurance premium was still higher at 70 per cent.
Another important channel for distribution of health insurance business is brokers, who contributed 24 per cent of the total health insurance premium.
During 2015-16, the general insurance and stand alone health insurance companies have settled 80.35 lakh health insurance claims and paid Rs.21,759 crore towards claims. In terms of number of claims settled, 73 per cent of the claims were settled through TPAs and the balance was settled in-house.
In terms of mode of settlement of claims, 58 per cent of the total claims were settled by cashless mode.
Insurance companies bet big on future growth opportunities in the health segment. According to various estimates, less than one-fifth of the Indians have health insurance policies. For non-life insurance firms, health is the second largest line of business after motor.
Many insurers also offer wellness programme or value added service in their products as an additional/ optional benefit.