One of the things we foresee happening is standard deductibles that are part of the tariff. For example, a policy has a deductible clause of Rs 5,000. For every claim that arises, the first Rs 5,000 is borne by the insured. This will inculcate more discipline and will help in lowering premium rates.

•Often hospitals charge an insured patient more compared with one who is not insured. What is ICICI Lombard doing to check this practice?

Personally, I think what will change such practices is penetration. The amount of billing paid by insurance companies is very little right now. Out of the total health care spends of the country, insurance does not pay too much — just 1-2 per cent. When penetration increases and insurance billing becomes significant, this equation will change.

Third Party Administrators (TPAs) play an important role in health insurance. Although their number is huge, their service levels are low. Sometimes, hospitals and patients complain about delayed payments from TPAs. We have set up an in-house TPA and have a large setup in Hyderabad. We expect this to improve service levels.

•Have you blacklisted hospitals that indulge in such malpractices?

We haven’t blacklisted anyone yet. However, we are in the process of identifying a preferred network of hospitals.

•How about health insurance? Are you working on new policies there?

Some amount of penetration exists in motor insurance because it is mandatory. Health insurance penetration, on the other hand, has miles to go. Here, we are developing a top- up plan. The cost of treatment is rising. Usually people in the organised sector depend on the cover provided by their employer, which is usually for Rs 50,000 to Rs 2 lakh. Through this plan, the insured can top up their insurance cover. In the case of an eventuality, first the employer’s cover comes into effect and then the top-up one.

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