Insurers may charge 50% more for high-end hospitals

You might have to shell out 50 per cent extra premium to get treatment at the country’s high-end hospitals.

Following the uproar over withdrawing cashless health insurance claims from high-end hospitals, state-owned non-life insurers are working on a product with differential rating that will bare the expenses of the top hospitals.

The four insurers – New India Assurance, United India Insurance, National India Insurance and Oriental Insurance – are designing a product where a person can pay around 50 per cent higher premium to avail the luxury. The insurance companies censored cashless facility at these hospitals from July 1 for erratic charges levied by them.

A senior executive of a public sector insurer said a differential rating is being worked out. “We are going to collate the data from all TPAs (third party administrators). Premium will be based on the number of people treated and the total claims paid. Policyholders will have to shell out more to be treated at these hospitals. It would be around 50 per cent more than a normal health policy.”

“This product was always on the drawing board of all PSUs. The recent outcry will only expedite the process. We will approach the regulator soon,” said G Srinivasan, Chairman and Managing Director of United India Insurance.

For instance, if a 30-year-old person was paying Rs 1,400 for his health insurance policy, he would now have to pay around Rs 2,000 to avail services of the high-end hospitals.

“Hospitals have been enjoying all this while at the cost of insurance companies. Now it is time to bring in some regulations,” said a senior executive of New India Assurance.

Since insurers are yet to work out the modalities they have not yet approached the regulator. The four insurers have prepared a new list of hospitals striking off names of several big hospitals. They are working on a preferred provider network.

“Hospitals have been charging rates which are in excess of what is justified. Our TPAs have been talking to hospitals over a long period to rationalise the charges. It results in customers exhausting their policy limits early,” said Srinivasan.

The industry has paid a claim of Rs 11,000 crore as compared to Rs 8,000 crore earned from health insurance in 2009-10. This segment has been bleeding non-life companies for the last two years.