The health insurance market in India grew at 34%, collecting a total premium of Rs 73,300 crore during 2021-22, says a knowledge paper prepared by National Insurance Academy, Pune, and Insurance Foundation of India, New Delhi. The growth has been steadily around a CAGR of 24% every year, particularly during the pandemic time, the paper said.

The paper on “Health Insurance in 2042, challenges and opportunities” attributed the continued increase in the health insurance business to improved awareness due to the pandemic, which made almost every individual in the country health-conscious. “A large number of customers have also realised the importance of adequate health protection for their families with wider coverage of diseases including pre-existing, critical illnesses and also pandemic specific covers, etc.

Another major reason for the growth is the increased coverage of people under government-sponsored health insurance schemes. Particularly, Ayushman Bharat Pradhan Mantri Jan Arogya Yojana (AB-PMJAY), which, introduced in 2018, has become one of the largest government-subsidised health insurance schemes in the world, covering nearly 50 crore individuals (40% of the population) in the country”, the paper points out.

It also states that nearly 20% of the population is covered by the social insurance scheme, including various state insurance schemes, Employee State Insurance Scheme (ESIS), and other private insurance schemes. “The Employee State Insurance Scheme covers nearly 13.6 crore employees, followed by various state insurance schemes, which cover nearly 12.4 crore individuals mostly economically weaker section (BPL & unorganised sector) of the population.

Further, some government departments have separate schemes for their employees. These are generally not insurance schemes. They directly provide healthcare services through self-owned and operated dispensaries and hospitals. The third type of health insurance coverage is private health insurance, which covers nearly 11.5 crore individuals and employees from the organised sector. All these schemes have taken the total coverage of health insurance to nearly 70% of the population, protecting the health care needs of 70 crore individuals in the country”, the paper explains.

However, 30% of the population does not have any kind of health insurance protection. The paper cited lack of awareness, affordability and easy access as well as non-availability of customised products. Exclusion of pre-existing diseases, no OPD cover, expensive premium rates, lack of trust, etc, have also been highlighted.

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