Group Health Insurance

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The Indian health insurance market is witnessing a rise in demand for more comprehensive and customized health coverage plans. This has led to expansion in the private health insurance products available which has unveiled newer avenues of growth for the insurance industry. In the last ten years, it has grown at a CAGR of 23%, making it the fastest expanding sector in the non-life insurance market, with a marketplace share of 24%. It has also received significant investments in recent years, particularly foreign direct investment; and accounted for 36% of total investment in 2018. This article focuses on customers’ satisfaction with their health insurance coverage.

Customer Satisfaction Level

Medical Insurance received an overall satisfaction score of 8.2 out of 10 from the PwC Health Insurance Consumer Pulse Survey.

While many customers assume that health insurance coverage is difficult to understand, the involvement of agents in giving crucial facts to consumers and ensuring a simple buying experience adds considerably to customer satisfaction. Despite the fact that service encounters are infrequent, the experience is positive. The satisfaction level with the claim procedure was likewise quite high.

Scores of Satisfaction during the Healthcare Insurance Journey

Across the different stages of the health insurance journey, satisfaction levels of customers are as follows:

  1. Research and access to health insurance plan information received a satisfaction score of 8.3 out of 10
  2. Purchasing insurance through a distribution channel received a satisfaction score of 8.2 out of 10
  3. Formalities in the purchasing process received a satisfaction score of 8.3 out of 10
  4. Customer service after the sale received a satisfaction score of 8.2 out of 10
  5. Claim settlement procedure received a satisfaction score of 8.1 out of 10

Key Imperatives

Since FY16, medical insurance in the nation has risen at a CAGR of 20%. However, there is still room for expansion because retail health plans (not supported by the government) serve only about 3% of India’s entire population.
Based on previous experiences with SARS and MERS in other countries, the current situation is expected to result in a significant surge in demand.

These five major imperatives are critical to maintaining consumer satisfaction and the growth of the medical insurance sector.

  1. Digital Accessibility

    Young and digitally sophisticated Indians are rapidly placing an emphasis on ‘well-being’ and ‘wellness.’ The current COVID-19 pandemic will almost certainly result in a further move toward online platforms. Market forces are pushing non-digital traditional customers to use online platforms as insurers and brokers are working to provide simple digital tools at every step of the medical insurance journey.


    According to the PWC consumer pulse poll, customers expect digital interactions at every step of their medical insurance experience, from research and study to renewals. As a result, insurers are required to offer digital products that deliver a consistent and straightforward experience at each point of the process.

  2. Innovative ProductsCustomers want cashless transactions, a broader selection of illness coverage, as well as reasonable premium rates. The recent IRDAI regulations have addressed most of these requests. Imperative: It is critical for insurers to have a better knowledge of their customers through basic research and analytics.
    To address unsaid or implied client requests, insurance providers should innovate on their behalf. Consumers, for example, did not want a modification but given that just 3% of participants agreed on any combination of features.  Insurers should explore developing configurable solutions that enable policy buyers to pick and select features.
    They are also required to make the greatest use of emerging technology, like IoT and wearables, in conjunction with analytics to reshape the marketplace.
  3. Painless Claim Process

    The performance of claim settlement has been enhanced.

    PWC customer survey shows a high satisfaction rating, demonstrating that insurance providers are already detecting and minimizing negative claims experiences.

    The causes for discontent with cashless claim settlement basically include:

    1. A shortage of network hospitals and medical centers
    2. Less than complete bill coverage,
    3. An absence of a dedicated hotline for issues and queries, and a shortage of procedure transparency.COVID-19 has pushed insurers to digitize and modernize claim settlement procedures. This change to digital formats is already happening among insurers, as well as it will assist them to guarantee that their efficiency is not affected by a sudden surge in demand.


      In light of the current epidemic, insurance providers should implement an online self-service claim submission facility to assure minimum personal interaction. This also boosts the simplicity of beginning reimbursement claims. They also need to invest in improved claim processing capabilities through the use of RPA (robotic process automation) for claims processing; but also AI (artificial intelligence) for scam and fraud analytics.

      Since a lack of transparency and advice is the leading cause of disappointment with the claim settlement process, insurers must provide effective communication to establish proper expectations and standards.

  4. Scale distribution Proficiency

    COVID-19 has fastened the pace of digitalization of insurance distribution.

    So far, traditional methods have dominated medical insurance distribution and customers’ faith in agents ensures that they will maintain to be the primary distribution route.

    The IRDAI’s revamped policy, outlined in its circular, allows for the establishment of fresh distribution streams without the need for lengthy authorizations. It will assist insurers in reaching a larger number of clients.


    By engaging in training courses and technology-enabled prompts to enforce changes in behavior, insurers may establish a scalable distribution network.

    Insurance companies can look for new and inventive business strategies as well as new-age collaborations. They have the ability to make the distribution journey modern, transparent, simple and, digital.

  5. Efficient Customer Service:

    Customers usually want to renew their health insurance, thus the matter is up to the insurance provider to take action.
    Communication breakdowns may be to blame for the lack of understanding regarding the free-look time. Furthermore, low volumes of service contacts are most likely due to the non-engaging character of present policies and plans.


    Insurers should tailor communication depending on customer categorization and experience.

To wrap it up:

Communication deficiencies must be filled, and clarity must be preserved in order to establish confidence. Insurers should also utilize context-dependent, engaging, and health-related goal-oriented communication. Thus, a comprehensive customer interaction structure that spans the full lifecycle must be established.

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