Page 305 - DMGT303_BANKING_AND_INSURANCE

Banking and Insurance

Notes
Exhibit 14.1: Some of the Factors Leading to Rising Healthcare

Factors Leading to Raising Healthcare Costs Expenditures

1. Rising hospital costs.
2. Greater emphasis and increased spending on drug/medicine therapy in the
treatment of diseases.
3. Rise in fees of health care providers.
4. Better medical facilities due to arrival of new medical technology, especially for the
treatment of conditions that were considered untreatable till now.
5. Increased consumer demand because of increases in life expectancy.

Comprehensive private health insurance must be based on:
1. Estimation of the total overall risk of healthcare expenses
2. Developing a routine finance structure (such as a monthly premium or annual amount)

3. Money is available (reimbursement) to pay for the healthcare benefits specified in the
insurance agreement when ever required.
4. Policies are administered by a central organization/government agency or a private or
not-for-profit entity operating a health plan.

14.7 Health Insurance Schemes (in India)

On the basis of ownership the existing health insurance schemes can be broadly divided into the
following categories:
1. Government or State-based Systems:
Central Government Health Scheme
Employees State Insurance Scheme (ESIS)

2. Market-based Systems (Private and Voluntary)
3. GIC Mediclaim Coverage:
Mediclaim or Hospitalization Benefit Insurance Policy
Domiciliary Hospitalization

Bhavishya Arogya Insurance Policy
4. LIC Coverages: e.g.
Jeevan Asha
Asha Deep

5. Private Insurers: e.g.
(i) Hospital Cash Daily Allowance Policy - Bajaj Allianz
(ii) Health Guard - Bajaj Allianz

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