History of Health Insurance in India

Health insurance in India has come a long way to becoming vital to the country's healthcare system. It plays a crucial role in reducing the financial burden of medical expenses for individuals and families. Learning about the history of health insurance in India will help you understand how it has evolved. So, let's delve into the evolution of health insurance in India, tracing its journey over the years.

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      The Origin of Health Insurance in India

      The foundation of health insurance in India dates back to the post-independence period. After achieving independence in 1947, the country began focusing on developing its healthcare system.

      Recognising the importance of structured health coverage, the government initiated below-mentioned programs starting in 1948:

      1. Employee State Insurance Scheme (ESIS)

        Launched in 1948, the ESIS was introduced to provide social security to blue-collar workers in the organised sector. Under this scheme, medicare services are offered through a network of empanelled dispensaries and hospitals. ESIS covers OPD & IPD expenses, and offer cash benefit to compensate for wage loss during medical emergencies. The scheme continues to operate today and is funded by contributions from both employers and employees.

      2. Central Government Health Scheme (CGHS)

        In 1954, the Central Government Health Scheme was introduced to cater to central government employees and their families. It aimed to provide comprehensive healthcare services to government employees and their dependents. This government health insurance scheme is still active and funded by employees and the government.

        These programs marked the beginning of organised health insurance in India, although they were limited in scope and catered only to specific population segments.

      Introduction of Mediclaim: Milestone in Health Insurance History in India

      In 1986, the General Insurance Corporation of India (GIC) introduced a standardised health insurance policy, i.e. "Mediclaim". This policy offered coverage for hospitalisation expenses while excluding pre-existing diseases (PEDs), maternity cover and childbirth costs, HIV/AIDS, and similar conditions.

      Mediclaim operated on the principle of indemnity, ensuring policyholders receive reimbursement for eligible medical expenses through a third-party administrator (TPA).

      Later, India's health insurance sector underwent a major transformation in 1991 with the introduction of economic liberalisation. This reform allowed private players to enter the insurance market.

      In 1999, the government took another critical step by establishing the Insurance Regulatory and Development Authority of India (IRDAI) to oversee and promote the insurance industry.

      The Current Landscape of Health Insurance in India

      India's health insurance industry has grown significantly, with currently 26 public and private companies offering a wide variety of mediclaim insurance plans. The health insurance penetration in India is increasing rapidly due to rising healthcare costs, government initiatives, and increased awareness.

      In fact, digital advancements like easy comparison of different health plans on websites like Policybazaar.com have also made it easier to purchase and manage medical insurance policies online.

      Moreover, IRDAI introduced TPAs in 2001, which act as a crucial link between hospitals and health insurance companies. They even enable cashless claim facilities for policyholders, further enhancing the efficiency and convenience of mediclaim in India.

      FAQs

      • Q1. When did health insurance start in India?

        Ans: Health insurance in India started in 1986.
      • Q2. What is cashless health insurance?

        Ans: Cashless health insurance is a type of mediclaim coverage that does not require you to pay upfront for medical treatments at hospitals. The insurance company directly settles the medical bills with the hospital, making the process hassle-free for you.
      • Q3. What is indemnity in health insurance?

        Ans: Indemnity in health insurance refers to a type of policy where the insurance company reimburses the policyholder for medical expenses incurred based on the actual cost of treatment.
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      Disclaimer: The list mentioned is according to the alphabetical order of the insurance companies. Policybazaar does not endorse, rate or recommend any particular insurer or insurance product offered by any insurer. For complete list of insurers in India refer to the Insurance Regulatory and Development Authority of India website www.irdai.gov.in

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      *We will respond in the first instance within 30 minutes of the customers contacting us. 30-minute claim support service is for the purpose of giving reasonable assistance to the policyholder in pursuance of the claim. Settlement of claim (including cashless claim) is the responsibility of the insurer as per policy terms and conditions. The 30- minute claim support is subject to our operations not being impacted by a system failure or force majeure event or for reasons beyond our control. For further details, 24x7 Claims Support Helpline can be reached out at 1800-258-5881.

      *Product information is authentic and solely based on the information received from the Insurer. Policybazaar is acting only as a facilitator and claims settlement shall be at the sole discretion of the Insurer. Policybazaar does not provide any medical or surgical advice or diagnosis and is not responsible for your interactions / treatment by a medical practitioner/hospital. Please consult a registered medical practitioner for any medical or surgical advice. The Information that you obtain or receive from Policybazaar, and its employees, or otherwise on the Website is for informational purposes only. As per the Insurance guidelines, you are allowed to cancel the policy with-in 30 days from the date of Issuance of policy.This option is available incase of policies with a term of one year or more.

      *All the health insurance plans cover hospitalization expenses including COVID-19 treatment cover up to the specified limits. You can also buy specific COVID-19 health insurance policies such as Corona Kavach Policy and Corona Rakshak policy.

      **All savings and online discounts are provided by insurers as per IRDAI approved insurance plans. #Tax Benefits are subject to changes in tax laws. GST Exemptions depend on fulfilment of qualification criteria and submission of relevant documents.

      *₹1748/month is the starting price for a 1 crore health insurance for an 18-year-old male, with no pre-existing diseases. Discount on renewal premium is subject to the number of wellness points earned in the health insurance policy. For more details about the plans, please read the sale brochure carefully to get upto 100% discount on renewal premium.

      *₹400/month is the starting price for ₹ 5 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹541/month is the starting price for ₹ 10 lakh Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹762/month is the starting price for ₹ 1 Crore Health insurance for a 30 year old male & 29 years old female, living in Delhi with no pre-existing diseases

      *₹243/month(₹ 8/day) is the starting price for a 5 lakh health insurance for a 20-year-old male, non-smoker, living in Bengaluru with no pre-existing diseases

      *₹2020/month is the starting price for ₹ 1 Cr Health insurance for a 50 year old male & 50 years old female, living in Bangalore with no pre-existing diseases rounded off to nearest 10.

      *₹390/month (₹13 per day) is starting price for 1 cr. Health insurance for 25 years old male, with pre-existing diseases, residing from tier 1 city rounded off to the nearest 10.

      *No medical tests are required unless requested by the insurer’s underwriter. In-case of pre-existing diseases relevant medical proof would be required as per the terms and condition of the policy opted.

      *The values taken for effective cost calculation are indicative values and may change as per the selected plan.

      *Coverage upto double the amount of Sum Insured is available on certain covers for a minimum plan of Rs. 5 Lakh on the first claim only to an individual of upto 45 years of age with no pre-existing diseases. The benefit is available with or without extra cost depending on the plan chosen.

      *Coverage of pre-existing diseases is provided by insurer as per their underwriting policy.

      *The scope of coverage may vary from plan to plan.

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