Introduction

The report presents a detailed examination of India’s nascent private health insurance sector, exploring the market structure, the key trends and the main opportunities. In doing so, it sets the private health insurance sector in the context of the wider health insurance market, which is relevant because privately-owned insurance companies often participate in both the private and social sectors.

Features and benefits

* Gain an insight into how Indias private health insurance sector relates to the wider social insurance sector.
* Understand the mechanics of the healthcare delivery chain, from insurers to third party administrators (TPAs) to healthcare provider networks.
* Identify key health insurance competitors (which includes both private and state-owned companies).
* Understand the latest trends in terms of pricing and procurement, and thereby avoid the pitfalls that have befallen a number of insurers.
* Gain an awareness of the main challenges that must be overcome in order for private insurance companies to achieve their full potential.

Highlights

Despite the rapid expansion of the private health insurance market in recent years, it covers less than 3% of the population, and many consumers remain unaware of the benefits of private health insurance. Indias private health insurance market is poised to grow at a CAGR of 25-30% over the next five years.
The market is likely to become much more competitive in future, with a growing number of foreign insurance companies likely to form joint-ventures with Indian partners.
A severe lack of data on consumers and disease patterns has prevented insurers from offering the same type of innovative policies that are available in developed markets. A high claims ratio, combined with problems in the supply chain, has made it difficult for health insurers to make a profit in the short term.

Your key questions answered

* What percentage of the population is covered by the various health insurance schemes (both private and social) that operate in India?
* What are the prospects for future growth in Indias private health insurance market?
* Who are the main players in Indias private health insurance market?
* What are the main pitfalls for companies operating in Indias private health insurance market?
* How do the mechanics of the market work?

Executive Summary
The private health insurance market in context
Market progression
Products and services
Procurement, pricing and expenditure
Corporate environment
Challenges and opportunities
About the author
Disclaimer
The private health insurance market in context
Summary
Introduction
RSBY scheme
RSBY hospitals
Expansion of RSBY scheme
ESIS
CGHS
New scheme to replace CGHS?
Other social schemes
Jan Aushadhi
Community/microinsurance
Private health insurance (big picture)
Market progression
Summary
Introduction
Genesis of insurance industry
Regulatory background
Emergence of health insurance market
Market structure
Vertical integration
Sales progression
Products and services
Summary
Introduction
Product/service types
Recent innovations
New vistas
HIV coverage
Portability
Procurement, pricing, and expenditure
Summary
Introduction
Private sector procurement
Public sector procurement
Drug pricing framework
Expenditure profile
Overcharging allegations
Medical association denies overcharging
Impact on insurers
Group policies lead to large losses
Cost containment measures
Case study: Price increases by Reliance General Insurance
Preferred Provider Network
Resistance to PPN
PPN expansion
Change to TPA landscape
PSUs plan new JV TPA
Private insurers’ relationship with TPAs
Corporate environment
Summary
Introduction
Recent trends
Profile of Star Health and Allied Insurance
Background
Health insurance products (private sector)
Performance
Outlook
Profile of Max Bupa Health Insurance
Background
Health insurance products
Performance
Outlook
Profile of United India Insurance
Background
Health insurance products
Performance
Outlook
Oportunities, issues and challenges
Summary
Introduction
Opportunities
Issues and challenges
Innovation
Consumer awareness
Financial pressures
Competitive environment
Appendix
Scope
Exchange rates
Methodology
Abbreviations
References
List of insurance companies