We are in the Business of Paying Claims

Antony Jacob, CEO of Apollo Munich Health Insurance believes that a robust IT platform and knowing details of the customer at the proposal stage helps reduce chances of claims rejection later. In an interview with Ritu Kant Ojha of The Indian Express, Jacob says, “We are in the business to pay claims”. Excerpts:

You are a fairly new player with 3 years in the health insurance market. How has the journey been for last 3 years? 

During the financial year 2011-11, Apollo Munich has garnered Rs 283 crores of GWP compared to Rs 114 crores in the year 2009-10, signifying a growth of 148 per cent compared to the last financial year. We have has insured over 27 lakh lives in the country.

Health insurance distribution has been challenging in India. How does a health insurance agent with a 15 per cent commission compare with the 30 per cent commission of a life insurance agent?

Yes, I believe that health insurance distribution has been a challenge till date. With the health insurance premium expected to grow at a compound annual growth rate of over 25 per cent for the period spanning from 2009-10 to 2013-14, this challenge does seem to be waning. All emerging trends clearly point to the fact that the Indian health insurance market is the new and lucrative growth avenue. The projected growth makes health insurance an attractive proposition for agents. Life insurance clearly constitutes a dominating share in the total insurance pie and has more sales persons promoting it, but I think what remains lesser known is that health insurance has the benefit of attractive commissions spanned equally over the life span of an agent.

Settlement of claims has always been an issue with health insurance companies. 

At Apollo Munich, we believe that we are in the business to pay claims. At the same time, we have an obligation to our shareholders to ensure that we pay genuine claims and have enough checks and balances in place to repudiate non-genuine claims. We have a robust IT platform and strong provider relationships to minimise such cases.

Ultimately, we also believe that if we very clearly explain to our customers what is covered and what is not and the circumstances under which claims are paid, we will be in a position to pay every single genuine claim.

What are the fine prints one must look at while buying a health policy? 

We advise health insurance buyers to take special notice of the following tips before signing on a policy: fill up proposal form yourself, know the exclusions, and read policy wording.

What is your break even point? Are you looking at raising long term capital through FDI if the cap is raised? 

I believe the health insurance business usually breaks even between the 5th and the 7th year of operations and we are on track to achieve the same. On the need for capital, our shareholders are committed to fund the growth plans of our company in line with the IRDA regulations.

There is a mandatory clause of rural sector obligations for the insurance companies. How is Apollo Munich doing on that front? 

Apollo Munich has participated in a few micro insurance projects, but to enter the rural insurance sector in a big way, we are trying to build our understanding of the requirements and the challenges of the sector.

In the last couple of years we have participated in the RSBY Meghalaya and Maharashtra project to get an experience of the issues and garner thorough knowledge of the needs of the rural folks. May be in a year or two we will be focusing more on the rural segment based on our experiences.