III Survey “Impact of

III Survey – Impact of Covid-19 on Health and Life Insurance (Released on 8th September, 2020)

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III Research/Covid-19/2 of 2020

Treatment

Health

LifeLife & Healthcare Treatment Cost

III Survey “Impact of

Covid-19 on Health and

Life Insurance”

September 2020

Thought Leadership Initiative of Insurance Institute of India

“Insurance is an important source of strength during the health

crisis and also in case of sudden death of the bread earner”


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Table

of

Co

nte

nts

About Insurance Institute of India

Introduction and Background of the

Survey

Question-wise Findings

Findings of the Survey

Conclusions and Recommendations


3

Insurance Institute of India (III) formed in 1955 as

a Federation of Insurance Institutes, is recognized by

the Indian Insurance Industry, SAARC countries

and many other developing insurance markets, as a

pioneer in insurance education, responding to the

academic needs of the industry as well as addressing

the causes of building and developing

professionalism. III certifications are internationally

recognized.

College of Insurance (COI) the training arm of III,

founded in 1966, provides training in all technical

and functional domains of Insurance. A large

number of private and public sector insurers,

brokers, surveyors, purchasers of insurance and

others benefit from COI’s classroom sessions,

workshops, seminars, industry research and

knowledge sharing activities. COI has a fully

functional campus in Kolkata, catering to the

academic needs of the Eastern and North Eastern

Regions of India and those of the neighboring

countries.

In view of the current restrictions on travel and need

to follow social distancing, COI has begun virtual

training from June 2020. (COI Virtual Training

calendar is available on - https://www.coi.org.in/

and on https://www.insuranceinstituteofindia.com

III's Research Centre is recognized by the

University of Mumbai for Ph. D. Research. It

conducts research studies for the Institute and for

reputed national and international entities. III fosters

research by supporting budding researchers through

research based essay competitions and by extending

financial support to researchers. Under its

Knowledge Management Initiatives, III reaches out

to around 1,00,000 practitioners of insurance and

keep them abreast of the latest in the industry every

week. Institute news is published on a monthly basis,

while the III Journal is quarterly.

Research Studies: Indicative

III Survey - Post Covid-19

Times - Strategic Concerns

for the Insurance Industry (June 2020)

Challenges in Insuring

Flood-prone areas of Mumbai – for General

Insurance Corporation of

India (2019)

Property Insurance in New and Existing Housing – for

National Housing Bank

(2019)

Insurance Requirements of

the Indian Logistics &

Warehousing Industry and

its Customers (In-Country Operations) – for Transport

Corporation of India (2017)

Country Landscape Study on Mutual and Cooperative

Insurers in India -

Cooperative and Mutual

Insurance Federation (2017).

Design and Product

Performance of the Industrial

All Risks Policy – for General Insurance

Corporation of India (2016)

Building Financial Resilience

of SAARC Countries against Natural Disasters: The

Insurance Option - SAARC

Disaster Management Center (2015)

Microinsurance Regulations

in India - Situational

Analysis and Assessment – for GIZ (2014)

About Us

https://www.coi.org.in/

https://www.insuranceinstituteofindia.com/


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Foreword

Health and life insurance support is a must in today’s world characterised by

increasing longevity. Insurance also helps manage finances, in case a need

arises for urgent hospitalisation.

Covid-19 situation typically raised some questions in the minds of people. e.g.

whether or not the existing policies cover Covid-19 related claims? What are

the expenses covered and which all are not covered? How much insurance is

adequate?

To know the pulse of insurance buyers, their understanding of policy related

conditions etc. Insurance Institute of India contacted a good number of

insurance buyers from all over India through the network of Associate

Institutes and conducted a survey.

The research team has collected and collated the data provided by 493

respondents in a structured manner. We are happy to present the findings

which could be of use to the Insurance Industry and the Regulator.

We are thankful to the participants for sparing time to respond to the survey

and offer valuable inputs.

Deepak Godbole,

Secretary General, Insurance Institute of India

Mumbai, India, 8th September 2020.


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Introduction and Background of the Survey

A large number of us probably will not remember any one event that touched as

many lives as deeply as the Covid-19 pandemic. Each and every one of us would

have encountered some sort of stressing vulnerability or at the very least, stressful

isolation. The public has understood that at the end of the day there is nothing of

more noteworthy significance than life and health. Since 11 March 2020, when

WHO declared Novel Coronavirus Disease (Covid-19) outbreak as a pandemic

and reiterated the call for countries to take immediate actions and scale up

response to treat, detect and reduce transmission to save the lives of people, the

world has undergone a change that will never make it the same again. The term

“new normal” is now here to stay as a way of life, perhaps forever.

At the beginning, the impact was great enough to cause the best of health care

facilities to collapse under the sheer magnitude of the numbers of Covid-19

patients. The WHO Country Office for India (WCO India) has been working

closely with the Government of India (GoI) to step-up preparedness and response

measures for Covid-19, including infection prevention and control, and

implementation of containment plan at all three levels of the health system –

national, state and district. The entire field presence, including the National

Public Health Surveillance Project, consisting of more than 2000 personnel has

been fully re-purposed to support the government to overcome this challenge.

In this scenario, the financial spend on health has suddenly spiked for those who

contracted the illness. The suddenness of this has left many struggling with out of

pocket spending thus pushing them further into poverty. Health Insurance

industry has reported a sudden surge in interest for health products. The regulator

responded with alacrity to the emerging situation and came out with a slew of

products to combat the situation and provide relief to the people. Over the last

few months these products have considerably evolved based on response from the

market to ensure that comprehensive cover is provided, which was finally given

shape to in the form of two policies launched some time back – Corona Kavach

and Corona Rakshak. The regulator also came out with special measures to be

adopted by the Insurance companies and Third Party Administrators to ease the

claim processing.


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We, at Insurance Institute of India, have been actively engaged with the market

to ascertain the response and effectiveness of the measures taken by the regulator

and companies. With this backdrop III has attempted a study to ascertain whether

in the situation of Covid-19 Pandemic, we can draw some inferences about

market sentiments vis a vis insurance emerging as a response to the pandemic and

its efficacy in dealing with the requirements of people. We have confined for

obvious reasons to Life and Health Insurance. We felt that particularly with

regard to the latter, new opportunities may present themselves. Hence the need

to explore the same.

The Objectives of this study were as follows:

To study the penetration level of health insurance and Life insurance

To find out if respondents were aware of the Covid-19 health and life

products launched during Covid-19 period.

To find out the willingness to purchase these products now due to

pandemic.

To study if the respondents were aware of the features of these products

and their satisfaction levels with them or if any additions were required.

To find out the about the awareness of the Government health insurance

schemes covering Covid-19.

Study of respondents with existing health plans, to understand their

awareness about the coverages vis a vis Covid-19.

To find out customers’ claim experience and the shortcoming thereof or

knowledge about claims procedures.

To understand awareness level amongst the public of the updates being

issued by Insurance Regulator frequently on Covid-19.

The sample of respondents - 493 for this survey was taken from various cities and

states and it is a random sample drawn mostly from people known to us or our

friends or their friends. The questionnaire was circulated through III’s Associated

Institutes in order to collect views from across the country.


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Limitations of the study: The respondents belong to a specific universe of educated

and professional people who may have a connection with insurance industry, hence

the findings of the study could be skewed to that extent.

The study was undertaken during August 2020 and experiences of people keep

changing as time progresses.

The Research Team: The study was carried out by Mrs. Madhuri Sharma, Faculty,

College of Insurance, with the support of Mrs. Akshara Nagpal and Ms. Laxmi Joshi

of III Research Team.

Mr. Deepak Godbole, Secretary General of III, Mr. Muktesh Chaturvedi, Director

of COI and Dr. George E Thomas, Professor, COI contributed variously to the

success of the study.


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46% respondents were from the age bracket of 35-50 years, denoting the working

population, followed by 32% between 50- 70 years (a mix of working, partially

employed and superannuated). 16% of the respondents were in the age group of 25-35

years and 4% were in the age group of less than 25 years.

Age

RESPONDENTS’ PROFILE

Less than 25 years, 4%

25 yrs - 35 yrs, 16%

35 yrs – 50yrs, 46%

50 yrs to 70 yrs, 32%

70 and above, 2%

Age of Respondents


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Out of the total respondents 82% were males and 18% were females.

Responses to the survey were mostly from the states of Maharashtra and Tamil

Nadu. This could be perhaps on account of more Covid-19 cases being reported

in these two states.

Gender

State/ Union Territory of Residence

Female 18%

Male 82%

Gender

35%

12%9%

6% 5% 4% 4% 4% 3% 3% 3% 2% 2% 1% 1% 1% 1% 1% 1% 1% 1%0%5%

10%15%20%25%30%35%40%

State/Union Territory


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Nature of Employment

Private sector48%

Government service

22%

Self Employed12%

Retired from service

11%

Not employed7%

Nature of Employment

48% of the responses to the survey came from those working in the Private Sector,

while 22% responses were from those in Government employment. 12% came

from Self-employed people, 11% from retired employees and 7% from unemployed

people.


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Number of Life Insurance policy holders

Question-wise Findings

The survey showed that 82% of the 493 respondents had a Life Insurance Policy.

Amongst the 82% of people who had a policy:

52% were in the age bracket of 35-50 years, 32% in 50-70 years’ age group,

14% in 25-35 years and 2% in the less than 25 years of age group.

54% were employed with private sector, 24% were in government

service,12% were self- employed,4% not employed and 6% were those

who had retired from service

72% of the female respondents had Life insurance policies (28% did not

have). Similarly, 84% of the male respondents had Life insurance policies

(16% did not have).

Yes82%

No18%

Percentage of Life Insurance Policyholders


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Sum Assured opted for in a Life Insurance Policy

Of the respondents, it was seen that

34% have opted for > 40 Lakhs of Sum Insured

24% have gone for 0-5 Lakhs of Sum Insured

21% have opted for 5-10 Lakhs of Sum Insured

11% opted for 10-20 Lakhs of Sum Insured

10% were in the range of 20-40 Lakhs of Sum Insured

Amongst those having Life Insurance policies 45% opted for range of 0-10

Lakhs, 21% were in the middle ranges of 10-40 Lakhs and a good 34% had sum

assured of more than 40 Lakhs.

Another rather surprising finding is that this 40 Lakhs and above segment was

dominated (90%) by those working in the private sector and self-employed people.

0- 5 Lakhs24%

10 – 20 Lakhs11%

20- 40 Lakhs 10%40 Lakhs and

above 34%

5-10 Lakhs21%

Sum Assured opted for Life Insurance


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Willingness to buy life insurance policy?

Out of those 18% respondents who did not have a Life Insurance policy, it was observed

that:

Although a huge 76% were not interested to change from their uninsured status, a

healthy 24% of hitherto uninsured showed their willingness to purchase Life

Insurance. This could be possibly an effect of the Covid-19 situation.

The breakup of this 24% who are likely to buy Life Insurance is as follows.

o 43% - age group of 25-35 years,

o 29% - age group of 35 to 50 years,

o 14% - age group of 70 years and above,

o 9% - age group of less than 25 years and

o 5% - age group of 50 -70 years.

32% of the uninsured females expressed willingness to buy Life insurance (the

remaining 68% were not interested), while 21% of the uninsured males were

willing to buy Life insurance (79% were not interested).

Looking at the employment profile of the uninsured respondents exhibiting

willingness to buy, it was found that employees in the Private sector showed the

highest level of willingness at 43%, followed by the unemployed respondents at

24%. 14% were in government service, 9.5% had retired from service and another

9.5% were self-employed.

Unlikely, 49%

Can’t decide, 27%

Likely, 12%

Extremely likely, 6%

Mostly Likely, 6%

Willingness to buy Life Insurance Policy


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Number of Health Insurance Policyholders

It was observed that 78% of the respondents have health insurance policies and

out of this

53% were working in private sector, 21% Government service, 11% self-

employed, 11% retired from service and 3% not employed.

52% were in the age group of 35-50 years, followed by 32% of 50-70 years,

13% from 25-35 years, 2% are from 70 years and above and 1% under less

than 25 years.

66% of the female respondents had Health insurance policies (34% did not

have). Similarly, 80% of the male respondents had Health insurance

policies (20% did not have).

No, 22%

Yes, 78%

Percentage of Health Insurance Policy

Holders


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Sum Assured opted for in Health Insurance Policy

From the responses it is observed that 26% respondents have opted for 0-5 lakhs of

Sum Insured and 26% for 5-10 lakhs. Another 18% respondents have 10-15 Lakhs

Sum Insured.

An analysis of respondents who have opted for 0-15 lakhs (69%) shows that:

85% of respondents in the age group of 25-35 years have opted for Sum

Assured of less than 15 Lakhs. Similarly 79% in age group of 35-50 years

have sum assured of less than 15 Lakhs.

48% of respondents in 50 years to 70 years of age band and 44% of

respondents in the age group of 70 and above have opted for Sum Insured

less than 15 Lakhs.

73% female and 69% males have opted for this Sum insured range.

81% of private sector employees, 87% of self-employed, 39% of retired from

service and, 36% of Government servants have opted for this Sum Assured

range.

An analysis of profile of those (31%) respondents who have opted for higher SI

>20 Lakhs:

56% of those in the age group of 70 and above and 52% of those in the age

group of 50 years to 70 years had opted for Sum Insured of more than 20

Lakhs. However, it cannot be said if they have bought a policy of higher SI

or have gradually increased the SI on reaching that age bracket.

21% were in the age group of 35-50 years and 15% were in 25-35 years age

group.

31% males and 27% females have opted for SI > 20 Lakhs

64% of those in Government service and 61% of the retired employees have

opted for SI >20 Lakhs

Similarly, 18% of those in the private sector and 13% of those who were self

-employed had opted for Sum Insured of more than 20 Lakhs

People at a higher age group were found to have policies of higher Sum Insured.

Further analysis showed that 46 % of the high sum assured Health policies were in

the nature of Group or Employer sponsored schemes.


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Willingness to buy Health Insurance Policy

Can’t decide , 28%

Unlikely, 27%

Likely, 21%

Extremely likely, 13%

Mostly Likely, 11%

Willingness to Buy Health Insurance

It was found that 22% of the respondents did not have any health insurance cover.

While 55% of the respondents without health insurance were not willing to buy health

insurance, a significant 45% showed willingness to purchase Health Insurance.

To understand the potential of this category of people who were willing to buy

health insurance, further analysis was done and it was observed as follows:

53.6% of the respondents without health insurance in the age group of 25-35 years

showed willingness to buy health insurance.

51.5% of health uninsured in the age group of 35-50 years were also willing.

Similarly, 43% of those uninsured in the age group of 50-70 years were willing.

27% of uninsured respondents in the age group of less than 25 years were willing

to buy health insurance.

This willingness appeared more pronounced among uninsured males at 47.4 % as

compared to females at 39.4%.

61% among uninsured private sector employees, 45% of self-employed people,

40% of those in government service and 37% of unemployed people showed their

willingness to buy health insurance.

It was observed that 24% of the respondents who do not have a Life Insurance

Policy and 45% of those who do not have a Health Insurance policy have shown

willingness to buy Life insurance and Health insurance respectively.


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Awareness about coverage of treatment for Covid-19 in a Health Insurance Policy

Awareness about Covid-19 specific policies being launched during Covid-19 period?

Awareness about the fact that Health Insurance policies do cover Covid-19

treatment was good (79%) across all respondents. Efforts by the insurance

companies and regulator seem to be effective in communicating to the public.

Do not know11%

No10%

Yes79%

Awareness of Covid-19 Treatment in Health

Insurance

Awareness about Covid-19 specific policies was good (80%) across all

respondents, which reflects that adequate media coverage has been given to

spread the required message by various companies, the Regulator and the

Government.


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Purchasers of Covid-19 specific policy.

No81%

Yes19%

Percentage of Covid-19 Specific Policyholders

Of those who responded, 19% have bought this policy and about them it was seen

that:

57% are in age group of 35-50 years, 22% in the age group of 50-70 years,

18% in 25-35 years and 3% in less than 25 years’ group

Amongst the males 21% had bought this policy and amongst the females

6% had bought it.

69% of those were from the private sector, 13% from government service,

9% from self-employed category and 7% retired employees

Among the people who have purchased the specific Covid-19 health insurance

product, 97% already had a Health Insurance policy.


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Willingness to buy Covid-19 insurance policy

Of the respondents, 32% stated that they were not able to decide, while 20%

were unlikely to purchase and the balance 48% were willing to buy.

Looking closely at the 48% who were willing to buy, it was observed that:

Gender-wise

57% of the males were interested in buying the specific coverage

Age-wise

In the age group of 25-35 years, 71% were willing to buy

In the age band of 35-50 years, 60% were willing to buy

In the less than 25 years of age band, 29% were willing to buy

In the age 50-70 years age group, 27% were willing to buy

Employment-wise

75% of those respondents who were self-employed,

59% of those employed in private sector,

43% of those in government service,

13% of the respondents who had retired from service and

11% of those who were not employed, were most likely to buy the Covid-

19 policy.

Can’t decide , 32%

Extremely Likely , 11%

Likely , 27%

Most Likely, 10%

Unlikely, 20%

Wiillingness to buy Covid-19 Policy


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Awareness about Covid-19 product features/conditions

There is good awareness of the features of the policy across all age groups and

gender. Importance of coverage’s is well known to all respondents.

Type of insurance protection most sought in Covid-19 products

The above reflects that overall the desire for cashless method of payment on

hospitalization is more amongst respondents.

2%

8%

9%

14%

15%

15%

18%

18%

0% 2% 4% 6% 8% 10% 12% 14% 16% 18% 20%

Other

You can pay the premium in installments

Not aware of any features

It has a waiting period before it pays out

You can avail of quarantine expenses

You need to be hospitalised for 24 hours

Cost of PPE kits and other consumables are covered

Gives the full sum insured on testing positive

Awareness of Features in Covid-19 Specific

Policies

1%

15%

23%

23%

38%

0% 5% 10% 15% 20% 25% 30% 35% 40%

Other

Get a fixed amount per day of hospital stay

Get a lumpsum benefit on diagnosis

Get hospital costs reimbursed

Get cashless hospital treatment

Features desired in Covid-19 Specific

Policies


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No16%

Yes84%

Awareness of Pradhan Mantri Ayushman

Bharat Scheme

Good awareness is there which is very encouraging and reflects adequate

efforts have been made in spreading the message about the scheme.

Coverage of Covid -19 treatment under PMJAY Scheme

No48%

Yes52%

Awareness of Covdi-19 Treatment under

Ayushman Bharat Scheme

Only 52% of the respondents were aware that Covid-19 treatment was

covered under PMJAY scheme. There is scope for more dissemination of

information on a larger scale on this.

Note: It is possible that most of the respondents being not eligible for PMJAY scheme,

their income being higher than the threshold, the respondents did not know the scheme

and its coverages in depth.

Awareness about Pradhan Mantri Jan Arogya Yojana (PM-JAY) also known

as ‘Ayushman Bharat’ Scheme launched by Government of India


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It was observed that the experience has been good with 69% of respondents

giving positive feedback, 25% giving an average feedback and only 6%

giving a negative feedback. The survey has probed into the reasons for this

negative feedback and the findings are given in the annexure in a concise

manner.

Experience of Health Insurance Claim processing by Insurance Company

4%

4%

21%

50%

21%

0% 10% 20% 30% 40% 50% 60%

Very Bad

Bad

Average

Good

Excellent

Experience of Health Claims Processing

by Insurance Company

Of the respondents, 71% gave a good review on their experience of Health

Insurance Claim processing by Insurance Companies.

21% gave an average feedback and only 8% gave a negative feedback. The

survey has probed into the reasons for this negative feedback and the findings

are presented in the Annexure in a concise manner.

Experience of respondents during Health Insurance Claim process at the hospital

3%

3%

25%

51%

18%

0% 10% 20% 30% 40% 50% 60%

Very bad

Bad

Average

Good

Excellent

Experience of Health Insured at the

Hospital


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25%

8%

17%

33%

17%

0% 5% 10% 15% 20% 25% 30% 35%

Very bad

Bad

Average

Good

Excellent

Experience on Covid Claims processed by

Insurers

However, when it came to claims related to Covid-19 treatment, only 50% have

given a positive feedback while 17% have reported an average experience while

33% reported a negative experience. The survey probed into the reasons for this

negative feedback and the findings are given in the annexure in a concise

manner.

Experience during Death claim processing due to the Covid-19 pandemic

21%

5%

26%

37%

11%

0% 5% 10% 15% 20% 25% 30% 35% 40%

Very bad

Bad

Average

Good

Excellent

Experience of Claim Processing in case

Death claims

It was observed that 48% of respondents were happy with the claim settlement

experience whereas 26% reported an average experience, and 26% gave a

negative feedback. Possibly the efforts of the regulator in giving specific

instructions to make the process hassle free and smooth has helped the industry

to some extent during this tough times. The negative experience though a

matter of concern could be possibly due to Covid-19 situation which could have

made documentation difficult.

Experience of Covid-19 claim processing done by Insurance Companies


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Awareness about the updates by the Insurance Regulator appeared good at

65%. However, considering that the people who have responded to this

survey may have better insurance awareness, more efforts might be required

to reach out to the masses.

No, 35%

Yes , 65%

Awareness of the updates by the Insurance

Regulator related to Covid-19

Awareness about updates issued by the Insurance Regulator relating to Covid-

19 from time to time


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The survey of 493 respondents across age groups, gender and occupation was

carried out to understand insurance awareness and certain issues and concerns

with reference to the Life and Health Insurance Industry.

The findings provide an overview and summary of key analytical points of the

survey.

1) Age and Gender: The responses from the survey indicate that more

respondents in the age bracket of 35-50 and 50-70 years have a Life

Insurance policy. An almost equal number of females and males are

policyholders showing that financial literacy is on the rise amongst

females too.

2) Sum Insured: It was observed that amongst those having Life Insurance

policies 45% have opted for range of 0-10 Lakhs, 21% were in the middle

ranges of 10-40 Lakhs and a good 34% had sum assured more than 40

Lakhs. Another rather surprising finding is that this 40 Lac and above

segment is dominated (90%) by private sector employees and self-

employed group.

3) Willingness to buy (Life Insurance): The study found that 18% of the

respondents did not have any Life Insurance. When asked about their

willingness to buy, 24% of these people indicated their willingness to

purchase Life policies. It was also observed that more females were

willing to buy policies than males. It is interesting to note that the other

segments that showed higher levels of willingness to buy were (a) those

in the age group of 25-35 years, (b) those between 35 and 50 years of age;

and (c) and those employed mainly with private sector followed by

unemployed and government sector. However, only 5% of those in the

age group of 50-70 years indicated an interest to buy.

4) Willingness to buy (Health Insurance): An analysis of the profile of

health insurance policy holders shows that out of the 78% respondents,

the largest group of policy holders is from private sector and in the age

group of 35 to 70 years. It was also observed that among the male

respondents 80% had a health policy whereas among the female

respondents only 66% had a health policy.

5) The Range of Sum Insured increases with age: It was observed that

more respondents in the younger age group of 25-35 years had opted for

0-15 lakhs of Sum Insured compared to higher age groups which have

shown preference for more than 20 lakhs of Sum Insured.

Snap-shots from the Survey:


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In the first segment where the sum insured was less than 15 lakhs, 81%

were from private sector and 36% from government service, whereas in

the second segment it was the reverse, 64% from government sector and

18% from private sector had opted for more than 20 lakhs of Sum

Insured.

People at higher age groups were found to have policies of higher Sum

Insured. Further analysis shows that 46 % of the Health Policies having

high sum assured were Group or Employer sponsored schemes.

6) There is more willingness to buy: It was observed that 22% of the total

respondents did not have any Health Insurance policy. Of these, while 55%

were clear that they did not want to buy, 45% conveyed that they were

interested in buying Health Insurance.

Of these, 53.6 % of the respondents without health insurance in the age

group of 25-35 years showed willingness to buy health insurance. In the

age group of 35-50 years it is 51.5%, which reflects the growing interest of

the youth post Covid-19 to secure themselves financially on account of

health risks. Of the males 47% have shown more interest than 39% of

females. Private sector, self-employed and government servants have all

shown good interest.

A comparative analysis shows that 24% of the respondents who do not

have a Life Insurance Policy and 45% of those who do not have a Health

Insurance policy have shown willingness to buy Life insurance and a

Health Insurance policies respectively.

7) The Public in general, has good awareness about Covid-19 insurance:

The awareness about coverage of Covid-19 treatment in a health Insurance

policy and about specific Covid-19 products and its features is good in the

market, reflecting that the regulator has been effective in dissemination of

information in this regard though the scare created on account of high

medical expenses could have also been a contributory factor.

8) Purchase of Covid-19 products: Out of the respondents 19% had bought

a Covid-19 specific product, mostly from the age group of 35-70 years. 69%

of them were from the private sector, 13% from government service, 9%

were from self-employed category and 7% of retired employees had bought

the products.


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Considering that among the people who purchased the Covid-19 product, 97%

already have a Health Insurance policy, one can surmise that the new products

served to fill a specific need-gap in the market.

9) It was observed that the willingness to purchase the Covid-19 specific product was

more amongst the younger age brackets (In the age group of 25-35 years, 71%

indicated their willingness to buy and in the age band of 35-50 years 60% were

willing to buy) Those who were self-employed and working in private sector,

amongst them 75% and 59% respectively were willing to buy.

10) There was good awareness about Regulator initiatives on Covid-19 Insurance.

It is possible that the good awareness levels about Regulator initiatives could be

because a good number of the respondents might have some connect with the

insurance industry. More efforts might be required to reach out to the masses.

11) With regard to Flagship Health Scheme of Government – PMJAY Ayushman

Bharat there is good awareness which is very encouraging and reflects that efforts

made by government agencies in spreading the message about the scheme have

been effective.

The survey has made an attempt to understand the preferences of the public regarding

the type of treatment desired while going for a Health claim and their experiences

while availing of those treatments. The following were observed:

a) Many respondents desired the cashless method of payment on hospitalization.

b) Had good experience with claims processing at the hospital as well as with

Insurance companies. Almost 70% respondents who have availed treatment

reported a positive experience overall.

c) However, when it came to Covid-19 related claims, only half of those who had

preferred claims reported a good experience about availing the treatment and

48% in case of death claims have given a positive feedback.

d) Some negative experiences were reported as part of the study. These were about

claims processing/ treatments at hospitals, insurance companies and Third

Party Administrators, mostly relating to overbilling, delays in pre authorization,

delay in settlement, cumbersome discharge procedures, deduction of expenses

without giving any reasons, to name a few.

Possibly the efforts of Regulator in giving specific instructions to make the claims

process hassle free and smooth during the times of Covid-19 has helped the industry

to some extent during these tough times. The negative experiences though a matter

of concern could be possibly due to impact of the Covid19 situation on multiple

agencies which could have made documentation difficult.


28

Conclusion and Recommendations:

Keeping in view the limitations of the survey, it can be concluded that there

appears to be good scope for growth of both life and health insurance, as there

is a lot of awareness generated post Covid-19

1) Based on the results it is recommended that the companies should focus

more on the younger age group within 25-35 years so as to catch them

young when the premium would be low with less chance of adverse

selection, thus ensuring a profitable portfolio.

2) There is a lot of scope for insurance companies to explore how higher

sum insured policies can be pitched to younger age groups, across various

employment segments as the survey indicates greater preference

exhibited in Private sector. This would offset the high claim ratios

emanating from higher age groups with large sum insured amounts.

Perhaps hybrid plans –savings combined with health insurance plans to

take care their medical needs in advanced years.

3) It is recommended that for Covid-19 specific products, the companies

must reach out to the age group of 25-35 years segment as considerable

interest has been expressed by this group

4) Due to increase in financial literacy amongst females, specific health

products be designed to target this segment and more outreach created

for them.

5) Dissemination of information about claim processing and procedures

should be done in all languages and circulated widely by the regulator.

6) Hospitals should be given TAT for discharge processes and Ombudsman

be set up to look into the grievance against them.

7) For reaching out to the younger age group digital platform needs to be

ramped up and user friendly interactive, personalized apps be deployed.

8) To ease the claims process during Covid-19 situation, a 24-hour helpline

to access the counsellors, information on travel, safety and security

related matters be provided free of cost by the companies.

9) Apps to address depression, anxiety and stress and wellbeing with an AI

driven chat function is required as a value addition for the customers.

10) Insurance companies, TPAs and hospitals need to be integrated

technologically so that simultaneous uploading of data can be done so

that all can access at the same time, thus saving considerable time.


29

Annexures:


30

1) Experience with Insurers/TPAs during claims processing

1 Claim reimbursement process is rather cumbersome, with too much documentation.

2 Co-ordination between insured and insurer is poor.

3 Delayed response to customer queries.

4 No-coordination between the Hospital and TPA before and after Hospitalisation, resulting in delays.

5 Lack of training to agent results in the lack of knowledge and creates problem for customer at claims finalisation time.

6 Lack of time management at Insurer and TPA for admission and Discharge at Hospitals resulting in avoidable delays

7 Formalities for claim settlement are not cleared at one go. Getting cash refund from hospital is very difficult.

8 Difference in Package rates for reimbursement and cashless patients.

9 Non-settlement of claims within stipulated time.

10 Some old pre-existing diseases, not known to patient manifest symptoms immediately after taking the policy and the claims get rejected on the basis of non –disclosure.

11 In some cases, expenses incurred at the time of claim are deducted without assigning any cogent reasons.

12 Investigation of doubtful claims takes large time to settle.

13 Long follow-up with TPA and repeated documentation leads to late disbursement of claim.

14 Shortage of Net-Working Hospitals leads to chaos for prospective patients.

15 Requirements formalities given by TPA during the claim process are too many as a result of which, claim reimbursement takes too long.

16 Pre-authorization approval for cashless treatment is very difficult and time consuming.

17 TPAs did not respond to communication.


31

2) Experience with hospitals during claims.

1 Pre or Post hospitalization claim process is very difficult and it is cumbersome to get money released from insurer.

2 At the time of discharge, hospitals take long time for discharge procedures with the excuse of late / delay in approval of cashless from Insurer / TPA. Disputes over Non Payable Items / Heavy Administration Charges can be very daunting

3 Patients are given expensive treatment packages which may not be really required.

4 There is delay in cashless pre-authorization and admission without taking full deposit and Excessive billing at the time of discharge.

5 Hospitals, have a tendency of overbilling if the customer is found to be covered by a health insurance scheme.

6 Unnecessary diagnostic tests are recommended to escalate the bills by the hospitals.

7 During Covid-19 treatment patients have experienced non cooperative and non-empathetic behavior from the hospitals

8 Hospitals are charging exorbitantly for Covid-19 treatments even for simple procedures.

9 There is no regulation on Pharma Industry, Hospitals or Diagnostic labs as regards the charges being billed to the customers.


32

The Covid-19 pandemic has revealed that the insurance world is not yet prepared to manage pandemic

situations. The most important aspect is that the virus cannot be defeated in isolation unless it is

defeated everywhere. It has also given us one great learning that we can only face this type of situations

through interdependence and global cooperation at economic, political and social levels.

Insurance Institute of India (III) has been a pioneering academic institution spreading Insurance

education and awareness since 1955 in India and also in multiple countries. III recognizes the

importance of cooperation with all stakeholders of the Insurance Industry at local and global levels. In

the process, in addition to conducting certificatory courses and examinations in multiple countries and

classroom training programs, III continuously provides platforms for exchange of ideas at local,

national and international levels through diverse channels like essay competitions, research reports, the

III Journal and other publications as well as thematic seminars, workshops and round table discussions.

One such round table discussion “III Virtual Round Table on Covid-19: Learnings for the Insurance

Ecosystem” was organized on the virtual mode on 8th September 2020, involving distinguished

dignitaries and thought leaders from Insurance Companies and Insurance Regulators of neighboring

countries including Bangladesh, Nepal, Bhutan, Sri Lanka, Maldives, Myanmar and Afghanistan. The

idea of this round table discussion was to share the experiences and responses of the insurance

ecosystem of different countries to the Covid-19 pandemic.

Mr. N D Kokare, Secretary, Insurance Institute of India (III), commenced the discussion by giving a

formal introduction to the activities of

Insurance Institute of India (III) and its

training arm, College of Insurance

(COI). This includes roles like

conducting training programs in different

streams of Insurance, conducting

professional examinations leading to

Licentiateship, Associateship and

Fellowship certifications, developing

study material, conducting researches

and surveys on Insurance related

subjects. He pointed out III’s mandatory

role in supporting the Insurance

Regulator as a training cum examining

body for Insurance Marketing Firms,

Health Third Party Administrators,

Web-Aggregators Corporate and

individual Insurance Agents. III trains

Insurance Brokers as well. In

collaboration with the University of Mumbai, III conducts Post Graduate Diploma in Health Insurance

(PGDHI) and in Insurance Marketing (PGDIM), as also Ph. D. Courses. He explained how III was

Release Function of III Survey – Impact of Covid-19 on Health and Life Insurance

(08th September, 2020) and ensuing deliberations at III Virtual Round Table on

Covid-19: Learnings for the Insurance Ecosystem


33

both responsible and responsive in playing its role for the Insurance Industry as it moved through

different phases during its journey of 65 years.

Mr. Deepak Godbole, Secretary General, Insurance Institute of India (III) welcomed the distinguished

participants and explained the context and relevance of the

Webinar. He drew their attention towards the new realities that

the pandemic situation had posed for the insurance industry

and the new challenges that were slowly unfolding before

insurers worldwide. The industry became aware of the low

insurance penetration and the new needs of the market. The

pandemic had forced the world to accept the new normal and

adapt to the same. Examples include working from home,

strengthening online customer servicing, realizing the futility

of high cost components like real estate and travel in running

the insurance business. Mr. Godbole suggested prioritization

of actions on Business Continuity Planning, Customer and

Employee Safety and Wellbeing, Crisis Management Task

Force, Stakeholder Communication, IT

Infrastructure Stability, Standardization

of Remote Working Practices and Cyber

Security. He pointed out that world’s

response to Covid-19 pandemic was

reactive as it was not ready for the same.

He informed that Insurance Institute of

India has responded well to Covid-19

situation by adapting to changes

immediately as required by the situation

including redesigning its courses,

resorting to online mode of training,

leveraging technology and undertaking surveys to understand the impact of Covid-19.

Mr. Muktesh Chaturvedi, Director, College of Insurance (COI), released the - Survey Report on “Impact of

Covid-19 on Health and Life Insurance" on this occasion. The

survey was conducted and prepared by III Research

Department. The survey attempted to ascertain how the Covid-

19 pandemic situation had influenced the sentiments of the

insurance market and to what extent the insurance industry

could respond to the requirements of people effectively. The

survey focused on Life and Health Insurance for obvious

reasons and tried to explore whether new opportunities

presented themselves. While explaining the importance of the

survey done, he pointed out about the negative effects of the

Covid-19 pandemic on human life and on the economy - by way

of disruption in supply chain, fall of interest rates, reduction in

insurance sales and renewals and disproportionate increase in health claims. He pointed out that neither

the affected countries nor the insurers were actually prepared for facing the Pandemic or its economic

fallout.


34

Mrs. Madhuri Sharma, Faculty, College of Insurance (COI), III presented an overview of the findings of

the Survey on “Impact of Covid-19 on Health and Life Insurance".

She shared the methodology adopted for doing the survey as also

the key findings, conclusions and recommendations for the

Insurance Industry. She added that the structured questionnaire

sent out by III’s Research Department directly and through III’s

Associated Institutes had received responses from 493

respondents from various cities and states of the country.

Thereafter, the Report on III Survey “Impact of Covid-19 on Health

and Life Insurance" was declared as released.

Prof. Archana Vaze, Assistant Professor, College of Insurance (COI), III initiated the ensuing discussions

and Round Table proceedings

and moderated the discussions

on the Impact of Covid-19 in

multiple countries. She requested

the distinguished participants to

share experiences from their

countries in the light of Covid-19

Pandemic and discuss the

insurance industry’s responses.

She urged them to talk about

matters of topical interest like

providing regulatory assistance,

introduction of new products, addressing legal concerns, application of Insure Tech and working from

home experiences.

Mr. Syed Moin Ahmed, MD, Green Delta Insurance, Bangladesh shared the experiences of Bangladesh

during Covid-19. The lockdown was first started on March 26 and extended till August. He opined that

Covid-19 had opened the eyes of insurance companies in Bangladesh. The pandemic had highlighted

the importance of Health Insurance, Retirement Benefits, development of IT infrastructures, and

designing the new products. Bangladesh Insurance Companies have witnessed huge number of

corporate queries for Insurance. Mr Ahmed stated that Life Insurance Companies of Bangladesh had

already extended their Health insurance coverages. They were also designing new Cyber and Pandemic

covers. The Covid-19 Pandemic had opened new opportunities for Insurers.

Covid-19 Experiences from Bangladesh:

Covid-19 Experiences from Different Countries


35

Mr. Chandana L. Aluthgama, CEO, Sri Lanka Insurance Corporation Ltd., Sri Lanka appraised the

participants about the Covid-19 situation

of the country. He mentioned that Covid-

19 cases were so far low in his country,

thanks to the various measures taken by

the Government, such as creating

awareness and declaring some services as

essential services. The Sri Lankan

Government had extended free Covid-19

cover for all officials fighting the Covid-19

pandemic in diverse ways. He informed

that the Government had declared various

financial concessions and credit facilities

to help citizens face the Covid-19 pandemic situation. He further informed that the insurance industry

had adapted to the new normal set by the government by embracing technology and working from

home, to serve the country.

Mr. Udeni Kiridena, CEO, Sri Lanka Insurance Institute (SLII) explained that the insurance industry of

the country had adapted to the changes very fast. The Insurance

Regulator, the Insurers, the Sri Lanka Insurance Association and the

SLII had realized the importance of collaborating and working with

better closeness during these difficult times. SLII was successful in

conducting online courses and online examinations during this period.

SLII officials visited Branch Offices of Insurance companies to

conduct Agents’ examinations maintaining social distancing norms.

In Mr. Kiridena’s assessment, the Country was on its way back to the

normal ways of working.

Mr. Bhoj Raj Sharma, Chief Executive Officer, Insurance Institute of Nepal and ex-Advisor, Beema Samiti

(Insurance Regulatory Authority of Nepal)

described the situation of Nepal in the face of

the Covid-19 pandemic. The country had been

through periodic lockdowns. Covid-19 cases

were going up, with a recovery rate of 65%. Mr

Sharma informed that the economy and the

GDP growth had been badly affected, the

supply chain had been thrown out of gear due

to lockdown conditions and migrant workers

had stopped sending remittances. The

hospitality industry, including tourism,

aviation, transport, agriculture and the insurance industry were very badly affected. He stated that the

Covid-19 Experiences from Sri Lanka:

Covid-19 Experiences from Nepal:


36

Insurance regulator had been playing its role to protect customers and that Insurers were not allowed

to reject claims due to the pandemic situation. The regulator had devised a Covid-19 policy to cover

Government employees. Mr. Sharma informed about the formation of an insurance pool to provide

cover for Covid-19 claims. The employees of the insurance industry had also adapted to the new normal

by working from home and selling policies on the digital platform. He pointed out that the Covid-19

pandemic had made people more aware about insurance.

Mr. Aung San, Chief Executive Officer, National Insurance Institute of Myanmar, informed that Covid-19

positive cases were still very low in Myanmar. The Government and the people were working together.

The Government had been taking various people-centric measures. Mr. Aung San further informed

that the impact of Covid-19 on the

overall economy was not too harsh

though there were some effects on

Insurance marketing and on the

transportation industry. The recently

opened up Insurance sector of

Myanmar had witnessed the Non-Life

insurers slowly trying to acquire some

share of the market, while Life Insurers

were still in the nascent stage. He

opined that as the Covid-19 pandemic

had increased the insurance awareness

of the people, adapting to technology

had become the need of the hour. He felt that the emerging scenario would help in the growth of the

insurance industry and hoped that there would be more recruitments in the Insurance sector.

Mr. Uz. Hassan Fiyaz, Executive

Director, Maldives Monetary Authority

spoke about the economy of Maldives.

He said that the Maldives was very

small country and the insurance

industry was also very small, with a

premium of around 60-million-dollars.

There were only 5 insurance companies

including one composite insurance

company. Maldives has a tourism

based economy and the Covid-19

pandemic had affected the tourism

industry badly. More than health of people, the pandemic had affected the economy of Maldives. The

Government had imposed lockdown and business was not happening. Covid-19 had affected Insurance

business in the country though there were very few numbers of claims due to the Covid-19 pandemic.

The Insurance Regulator was providing all necessary support to the Insurance Industry during this

Covid-19 Experiences from Myanmar:

Covid-19 Experiences from Maldives:


37

period of struggle. Mr. Fiyaz was hopeful that thing would be better once the lockdown was over and

the border was opened.

Mr. Mohamed Liwaz Latheef, Maldives Monetary Authority, added that the Financial Results had been

affected badly with a reduction of 25% in the premium of the second quarter. He too confirmed that

the Regulator has been continuously working with insurance companies and monitoring the situation.

In his opinion the new normal was likely to continue.

Ms. Yeshey Lhamo, Development Officer/ Assistant Manager, Financial Institutions Training Institute

(FITI), Bhutan sent her views

as a written note as the

communication networks

were not optimal.

She conveyed that on the first

detection of a Covid-19

positive case, His Majesty the

King initiated a host of

measures for the benefit of the

citizens of Bhutan.

Restrictions on gatherings

were imposed, schools were

closed, ‘work from home’ implemented, payments made through electronic modes, loan payments

deferred and measures taken to bring back citizens stranded in other countries. The Covid-19 pandemic

had affected Bhutan’s economy badly. In the month of August, the GDP was -6.7% because there was

zero revenue from Tourism and as all the businesses were closed due to the lockdown. With the

international border gates getting closed, the import of goods was affected and the construction industry

was affected. However, revenue from hydropower sector was not affected. She informed that Bhutan

has only two insurance companies the business of which were also affected negatively as project works

and import of vehicles etc. were halted. The use of technology had also increased but there was a

concern about cyber security.

Mr. Pradip Sarkar, Principal, College of Insurance (COI), Kolkata concluded the Virtual Round Table by

summarizing the takeaways. He

appreciated the speakers for sharing

the varied experiences and situations

of Covid-19 in their countries and the

impact of the pandemic on the

economy and the insurance industry.

He summed up the learnings from this

angle. He proposed the vote of thanks

to the participants and all others who

made the Virtual Round Table

successful.

Covid-19 Experiences from Bhutan:


38

The Research Department of III

profoundly thanks the respondents of this

survey.

We look forward to your feedback on this

survey and the outcomes.

Email: [email protected]

The information contained herein is based on survey responses from experts in the field of insurance, conducted

during July/ August 2020 during the lockdown period, consequent to Covid-19. Insurance Institute of India (III) and/ or College of Insurance (CoI) carry no obligation to update the Analysis/ Report.

This document and any recommendations, analysis, or finding provided by III are not intended to be taken as advice/ prescription for any individual situation or commercial decision, whatsoever.

Contents from this document can be reproduced by providing a reference to the source document and publisher and, by informing III through an email- [email protected].

For more information on III and CoI, visit http://www.insuranceinstituteofindia.com.

Thought Leadership Initiative of Insurance Institute of India

Country-wise COVID 19 Statistics

Country Cases Death Cured (Number) Cured (%) Active

India 4204613 71642 3250429 77.31 882542

Bangladesh 327359 4516 224573 68.60 98270

Nepal 47236 300 30677 64.94 16259

Bhutan 233 0 151 64.81 82

Maldives 8667 29 6052 69.83 2586

Sri Lanka 3123 12 2926 93.69 185

Afghanistan 38494 1415 30557 79.38 6522

As on 7th September, 2020 Source : https://www.coronatracker.com/country

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III Survey “Impact of