Leisure, Lifestyle & Wellness
Mediclaim: Use of Tertiary hospitals driving treatment costs higher

Cashless preferred for high cost treatment and medical inflation seen as moderating says the ICICI Lombard 2014 trends report 


ICICI Lombard General Insurance has released the key trends for 2014 and its outlook for 2015 for the Health and Motor insurance segments. Here are the important points and Moneylife's comments -  
Use of Tertiary hospitals increased from 43% to 49% in case of retail customers which influenced treatment costs. 32% of corporate cases are referred to tertiary hospitals.
Including tertiary hospitals (Hinduja, Lilavati, Breach Candy, etc) for cashless is good for consumers, but it can mean that the insured will go to these hospitals even for minor ailments. Insurance companies often overlook smaller nursing homes for including in cashless network, which can push the insured to go for tertiary hospitals.
Medical inflation was seen as moderating, especially in the last three years. Mediclaim premium of private and government insurers have drastically increased in recent times and we hope it will pause or increase minimally going forward
Cashless route continued to be preferred for high cost treatments. Cashless is an important feature for policyholders. The list of hospitals on cashless network, also known as preferred-provider-network (PPN), varies across insurance companies and is a dynamically changing list. The cashless hospital when you purchased the policy may no longer be on the network after some time. It causes inconvenience to the insured who may buy specific insurer mediclaim product after finding close-by decent hospitals to be on the PPN list. It is disappointing for the insured when the hospital is removed from the PPN list. Moreover, government insurers do not have prominent tertiary hospitals on their PPN in major cities. Recently, Pune, Chinchwad-Pimpri hospitals have stopped cashless for government insurers, retail customers even when group mediclaim customers  continue to enjoy cashless    
The key disease trends remained consistent in 2014 led by genito urinary, eye disorders, respiratory disorders, injuries and digestive ailments
The pattern was similar for critical illness as neoplasm, metabol ailments, heart ailments continued to dominate
Among the key trends likely to emerge/ strengthen in 2015 include:
Rising demand for OPD as is evident from initial response in group health segment. Mediclaim covering OPD (consultation, diagnostics) is an expensive product which is marketed for fully utilizing Sec 80D limit of Rs15,000 (Rs20,000 for senior citizens). If an insurer offers mediclaim covering OPD at an affordable premium, then the product will be a success. 
Consultation services driving OPD usage at 73%, while diagnostics remains at 27% usage. Insurers can tie-up private primary healthcare providers and general physicians from different cities to offer discounted consultation fees for mediclaim policyholders who may or may not have opted for OPD cover. 
E-cashless module will gain prominence in the year ahead
Motor Insurance 
Impact of natural calamities was clearly evident with 40% increase in claims arising out of storms/cyclones
Motor Insurance continued on the growth path, though pace of growth slowed (9.8% in April to November 2014 compared to 17.1% in April to November 2013)
Private car sales are being driven by hatchbacks, 40% growth in April to November sales 
Bikes segment continued to witness muted demand, scooters (132% growth) provided a silver lining
Among the key trends likely to emerge/strengthen in 2015 include:
Industry to benefit from road safety measures focused on increasing governance on manufacturers and penalties on violations
Introduction of DAIR (Detailed Accident Investigation Report) to reduce reporting time for insurers, waiting time for claimants
Usage based insurance, though nascent, may see an uptrend in the coming year


Arvind Panagariya to be first NITI Aayog Vice-Chairman

The Columbia University professor will take over as the Vice-Chairman of the newly form body, which will come under the PMO


Laying to rest and confirming all speculation, the Prime Minister's Office announced today the people who will be a part of the newly formed think thank and Planning Commission successor, NITI Aayog.


The body will be headed by the Prime Minister as its Chairman and will have Arvind Panagariya as its Vice Chairman.


Following is the list of all appointees as per the PMO statement:

Vice Chairman - Arvind Panagariya, Economist

Full-Time Members

  • • Bibek Debroy, Economist

  • • Dr. V.K. Saraswat, Former Secretary Defence R&D

Ex-officio members

  • • Rajnath Singh, Union Minister

  • • Arun Jaitley, Union Minister

  • • Suresh Prabhu, Union Minister

  • • Radha Mohan Singh, Union Minister

Special Invitees

  • • Nitin Gadkari, Union Minister

  • • Thawar Chand Gehlot, Union Minister

  • • Smriti Zubin Irani, Union Minister


IRB shares close lower by 8.43% on reports of CBI raid

The CBI has conducted raids on various offices of IRB Infrastructure Developers, in Pune and Mumbai


The Central Bureau of Investigation (CBI) conducted raids on various offices of IRB Infrastructure Developers, in connection with land grab cases filed against IRB and its Chairman Virendra Mhaiskar, by the murdered Right To Information (RTI) activist Satish Shetty. While the share saw an intra-day fall of a little over 10%, it closed the day down by 8.43%.


As Moneylife has written before , Shetty's case was suspiciously closed after over 4 years of investigations by the CBI. Shetty was murdered on 13 February 2010.


After the closure report in the case was filed by the CBI, it is now re-investigating the land grab accusations against IRB and its head. CNBC TV18 reported that the Bombay HC had allowed the CBI to re-investigate the land grab cases in the interest of justice.


Shetty was said to have been murdered for his refusal to take back the cases he had filed. The CBI's report had also said that IRB had offered Shetty Rs2 crore to take back the cases he had filed.


CBI's report in the murder investigation had said the following, “Investigations by CBI revealed that the deceased had filed a number of complaints against Smt Ashiwini Kshirsagar, the then Sub-Registrar at Lonavala, for illegally registering Government land on the basis of false documents. The deceased had filed a complaint on 16 September 2009 with the Superintendent of Police (SP) of Pune Rural, against Smt Kshirsagar and others, for registering government land on the basis of bogus documents. Therefore, on 15 October 2009, on the fresh complaint of the deceased CR no152/2009 a case u/s420, 467, 468, 469, 471 and 34 of IPC was registered at Lonavala City Police Station against Virendra Mhaiskar, director of Aryan Infrastructure Investment Pvt Ltd and 12 others regarding illegal purchase of government land in Pimpaloli village and Ozarde village, Maval taluka, Dist. Pune on the basis of fake and forged documents in connivance with Ashwini Kshirsagar, the then sub-registrar, Lonavala, who was also cited as an accused in the said FIR.”


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