HEALTH INSURANCE MANAGEMENT (NON-LIFE)

Background
Health insurance is expected to occupy major share in the portfolio of General Insurance companies. As the countries enter into the era of liberalisation, health insurance will have a critical role to play in supplementing public health expenditure and enabling the benefits of advancements on health care technology to reach wider section of population. The field is rapidly evolving with new products and systems of financing health care. Health Insurance is critical to us and can become a sizeable portfolio in the coming years considering our population of over 1 billion.

Health insurance has its peculiar problems of adverse selection against insurers and selection bias by insurers; moral hazard problems and issues of cost escalation and cost containment. Health Insurance products by general insurance companies are gaining acceptance. Quite a few financial institutions market also their products with health insurance covers as add-ons. Broking firms, health insurance consultants, health providers and TPAs take enormous interest in this segment.

Objectives
This programme aims:

• To provide participants with an overview of Health Insurance Systems around the globe

• To help participants examine the issues of morbidity and risk selection.

• To bring into focus an actuarial point of view of Health insurance

• To assist the participants in a study of various medical insurance products available for aborigines & Foreign travelers etc.

• To introduce the concept of Managed Health Care

• To introduce reinsurance concepts for covering high end risk

• Developing & designing new Health Insurance products for various segments like Sr citizens, younger generation, AIDs victims, Specified disease covers

• Niche marketing for high end consumers, for rural consumers and those exposed to occupational health hazards

Contents
• Insurance and health care - interface

• Morbidity risk and its treatment, Rating and selection for morbidity

• Actuarial Application of Health Insurance,

• Long-term care insurance, dreaded diseases cover

• New Health Insurance Products in international markets

• Managed Health Care, Munich Re & Swiss Re Experience

• Health Insurance for poor (Health & Micro Insurance)

• Medical Underwriting & Claims settlement

• Analysis of claims data & reduction of losses, Role of TPAs

• AIDS – Major Health Hazard

• Channelising Health Insurance Marketing in India

• Overseas Health Insurance Products & their Management