In a recent survey conducted by ACKO, a tech-first insurance company in India, it has been revealed that a significant majority of Indian health insurance policyholders are underinsured. The study highlights that 68% of policyholders have coverage below ₹10 lakh, with 27% having coverage under ₹5 lakh. This trend persists despite the escalating costs of medical treatments and the financial strain experienced during the COVID-19 pandemic.
Key Findings of the Survey
The survey, encompassing 1,000 respondents aged between 28 and 55 across six major metropolitan areas in India, sheds light on several critical aspects:
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Stagnant Coverage Levels: A substantial 64% of policyholders have not increased their coverage from the previous year, indicating a lack of adjustment in response to rising healthcare expenses.
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Perception of Adequate Coverage: Despite the increasing costs, 65% of respondents believe that a health insurance cover of up to ₹10 lakh is sufficient.
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Limited Awareness of Policy Features: While 60% of participants feel they understand their policy terms, their awareness is primarily limited to features like cashless treatment (53%), accident covers (50%), and 100% bill payment (45%).
Challenges in Health Insurance Awareness
The survey also uncovers several deterrents affecting both existing policyholders and potential buyers:
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Complex Claim Processes: Approximately 43% of respondents find the claim settlement process slow and cumbersome, discouraging them from engaging with health insurance policies.
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Insufficient Network Hospitals: A significant portion of policyholders (41%) and potential buyers (44%) express concerns over the limited network of hospitals associated with their insurers.
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Desire for Comprehensive Coverage: Nearly half of the policyholders (47%) and more than half of potential buyers (56%) are deterred by the lack of policies offering 100% bill payment, including consumables.
Preference for Family Floater Plans
Family floater plans emerge as the most favored option among both existing policyholders and potential buyers, with 71% and 72% respectively preferring them. These plans allow for the inclusion of family members under a single policy, offering convenience and broader coverage.
Implications and Recommendations
The findings of the survey underscore a pressing need for increased awareness and education regarding health insurance:
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Reassessing Coverage Needs: Policyholders should regularly evaluate their coverage in light of rising medical costs and consider increasing their sum insured accordingly.
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Understanding Policy Features: A deeper understanding of policy terms, including coverage limits, exclusions, and claim processes, is essential for making informed decisions.
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Exploring Comprehensive Plans: Consumers should seek policies that offer comprehensive coverage, including 100% bill payment and a wide network of hospitals, to ensure financial protection during medical emergencies.
Conclusion
The survey by ACKO highlights a significant gap in health insurance coverage among Indians, with a majority holding policies that may not suffice in the face of rising healthcare costs. It is imperative for individuals to reassess their insurance needs, enhance their understanding of policy features, and consider more comprehensive plans to ensure adequate financial protection for themselves and their families.