THE CONTRIBUTION OF GOVERNMENT SPONSORED HEALTH INSURANCE SCHEMES TOWARDS INDIAN HEALTH SECTOR

Abstract

Today, there are thirty four general insurance companies including the Export Credit Guarantee Corporation of India Ltd (ECGC) and Agriculture Insurance Corporation (AIC) of India and 24 life insurance companies operating in the country. Barring the AIC and ECGC, all other 32 insurers transact health insurance business, of whom six are stand-alone health insurers. Although there are number of insurers and different types of health insurance products available in the market, three-fourth health-insured Indians still gets covered only by a government-sponsored health insurance scheme (GSHIS) like PMJAY. Of all the health insurance premiums underwritten in the year 2019-20, 10 per cent came only from the GSHIS. In terms of number of persons covered, 73 per cent health-insured people are governed by one or other GSHIS. Looking at the profitability of the health insurer also, the incurred claims ratio is just 97.22 per cent in GSHISs. Thus, the health insurance premium, penetration and profitability—all of these are significantly sponsored and subsidized by the government through GSHIS, incorporating the public–private partnership (PPP) mode. This article details the role of GSHIS in the health insurance segment, taking the performances of the Indian health insurance sector in the year 2019-20. KEYWORDS: Government sponsored health insurance schemes, health insurance, health premium, incurred claims ratio, insurance, insurance regulatory and development authority, standalone health insurers.