PSU non-life insurers forgo premium, not to hike premium for staff and retirees

The Group Mediclaim Policy for the staff and retirees of the five government owned non-life insurers expires on March 31 and has to be renewed for a year from April 1.

Similarly for the retirees, the companies not only retained the old premium charged but also decided not to recover the 12.75 per cent premium that was due on their Group Mediclaim Premium.

The companies in question are National Insurance Company, New India Assurance Company, Oriental Insurance Company, United India Insurance and General Insurance Corporation of India.

"Charity should begin at home. At a time when the health insurance business is unprofitable and the premium for the general public is revised upwards regularly, employees and retirees of government owned insurers should pay adequate premium for the risk covered," the senior industry official told IANS on the condition of anonymity.

"In the case of retirees, the amount foregone is paltry which they can very well pay up. At the top most bracket, say for Rs.50 lakh sum insured the 12.75 per cent premium amount foregone will be about Rs 4,000. It will be much lower for those who have opted lower sum insured," the official added.

According to him, the policy is underwritten by insurers among themselves.

In a circular issued, the United India Insurance said The General Insurers' (Public Sector) Association of India (GIPSA) board at its meeting held on 27.1.2022 considered the claims data for 2020-21 (Covid-19 year) and for the first three quarters of 2021-22 (Covid-19 second wave year) for the Group Mediclaim Policy of the staff and the retirees of the five insurers.

The GIPSA has decided that the companies shall renew the Group Mediclaim Policies for their staff and retirees at the premium rate that was charged in 2020-21.

Based on the claims experience, the premium on the Group Mediclaim Policy for staff and retirees were loaded by 47.75 per cent in 2020-21 and was continued in 2021-22.

It was decided in 2020-21, the 47.75 per cent premium loading for the retirees to be spread over three years - 25 per cent in 2020-21, 10 per cent in 2021-22 and 12.75 per cent in 2022-23.

The GIPSA board has advised the insurers not to recover the 12.75 per cent premium due from the retirees while renewing their Group Mediclaim premium.

According to the industry expert, instead of foregoing the 12.75 per cent premium, the correct way is for the companies to pay up the shortfall.

It may be recalled, in 2021 the GIPSA had allowed the reimbursement of the cost of one pulse oximeter per family under the group mediclaim insurance policy for the staff of five insurers.

According to GIPSA, the reimbursement of pulse oximeter cost is capped at Rs 2,000.

It should be noted that, for the general public policyholders, the cost of pulse oximeter is not reimbursable.

Physicians heal thyself is passe. Insurers reimburse themselves is the new phrase.