Health Insurance: A Case Study On Its Existence

Posted on Nov 28 2015 - 2:31pm by Editorial Staff


Life is unexpected and you never know when you could get sick or hurt. You could probably work a few doctor’s bills and prescriptions into your budget, but what would you do if you got seriously ill or injured? Major diseases and injuries need long-term treatment, medication, specialist care, and sometimes even surgery, all of which do not come cheap. This is where a health insurance plan comes to the rescue. It can help protect your finances, while keeping you out of harm’s way.

The History of Health Insurance

The first forms of insurance that we know of were recorded by traders from Babylon and China. These traders would divide their items and load them onto different ships, so that if there was an accident, this would limit their loss of goods. Around 600 B.C., the Romans and the Greeks created the first kind of health and life insurance with charitable societies. These societies used to provide care to the families of deceased citizens. These kind of societies began to grow all over the world and, in some cases, the costs of funeral rites were covered within the policies.

Health Plans in India

Insurance in India has been around since ancient days. There are mentions of some sort of insurance in the Manusmriti, Dharmashastra, and Arthashastra. These records speak of citizens collecting resource and storing them so that they can be used in case of disasters, such as fires, famines, floods, and disease. There are also cases of the earliest cases of insurance in the form of carrier contracts and marine trade loans. After the invasion of our country by the west, the idea of insurance evolved.

According to an academic journal on Academia, prior to our Independence in 1947, healthcare was voluntary. However, this changed on the eve of independence when the Bhore Committee Report made recommendations to improve health care services in the country. After we became a free nation, the Government of India stressed upon primary health care and put in efforts to uplift the health care system in the country.

In the early 1950s, civil servants and formal sector workers were made to enroll in heavily contributory health insurance programs, namely the Central Government Health Scheme and the Employees’ State Insurance Scheme.

In 1999, after the liberalization of the economy and the rise of general awareness, the government opened up the private sector and health insurance programs were available under these sectors. This gave higher income groups the chance to have access to better quality private care facilities. However, in the last decade or so a host of new initiatives in the healthcare industry has transformed the country. The central government and the private sector have introduced more policies to ensure that there is an increase in public spending on health care.

The Policies Available

In India, health insurance is generally only covered for inpatient hospitalization and for treatment, only for hospitals in the country. The advent of health care under the private sector, brought in many products, such as top-up plans, family floater plans, critical illness plans, and hospital top-up and cash policies. Health plans can be broadly classified into three categories.


These are indemnity plans that pay only for the hospitalization and medical costs of the insured individual. The sum insured can be applied to a person on the basis of individual or family floater policies. In the case of floater policies, the insurance can be used by any of the members under the plan and does not normally pay a cash benefit. Some specific policies will offer to provide additional benefits, such as maternity and infant coverage, day-care procedures for specific surgeries, care of a patient both before and after hospitalization, care at home when a patient cannot be moved into a hospital, and coverage during convalescence.

There is another hospitalization coverage plan called a ‘top-up policy’, which is generally targeted at people who have a small insurance cover from their employers. If the insurance cover is not sufficient, you may cover the rest of the cost with a top-up policy. This policy is deductible, however, on every claim reported for every member under the plan and will eventually reduce the final amount payable.

Daily Cash Benefit Plans

This plan is a defined benefit policy that will cover a specific amount of money for every day that you or a loved one is hospitalized. The payments are usually for a defined number of days in a year and are subject to deduction over a few days.

Serious Illness Plans

This policy is a benefit-based one that pays you a large fixed amount of money if you have been diagnosed with a serious illness. The policy will cover some specific and highly severe diseases that are not common. The treatment amounts are also usually higher than normal daily medical expenses. You can use this policy in case of diseases such as cancer, heart attacks, strokes, or other fatal illnesses.

Why You Need a Health Plan

Health Insurance is important. When you have a health insurance plan, you can have more regular checkups and can undergo preventive care that includes screenings, vaccinations and more. This would help you stay healthy and prevent serious diseases, thus protecting you financially in the long run. If you are looking for one, ICICI Lombard is a good health insurance provider you can count on.You can also choose the coverage plan that you want, so that insurance is not expensive. You can also claim tax deductions on your health plan under Section 80D of the Income Tax Act of India, thereby making it more affordable.

By availing a healthinsurance plan, you can ensure that health issues will never disrupt your finances. You just need a little financial discipline and you will find that it is an investment that will keep your health and finances in one piece.

About the Author

Editorial Staff at I2Mag is a team of subject experts.