1. Samiran
kundu
A-06

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 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

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
Polamalu is famous
for more than his
moves on the field

19. Bruce Springsteen
knows his voice is a
hot commodity. The
Boss' pipes are
insured for $5
million.

20. 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.

21. “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.”

22. THANK YOU