Burning Cost prescription by Indian Regulator

What is New - General Insurance in India

Burning Cost prescription by Indian Regulator

To price Group health insurance, fire and engineering occupancies from 1st January 2015

Pricing of Group Health Insurance in India in 2015:

Post de-tariffing of market in 2007 the general insurers in India have free market approach to price their products except for motor third party insurance. Sustainable growth is the life line for any business and insurance is no exception to it. Insurers must have the 360 degree view of their business .The Regulator, who watches the interest of the policyholders, however observed that despite its advisories the free market regime coupled with intense competition amongst insurers & their obsession for the top-line is resulting into deficient assessment of insurable risks, in corporate sector, and that the prices are offered to these corporate clients for property insurance and group health insurance at non-viable rates which are ultimately subsidized by the buyers of retail products. Due to aggressive competition the insurers were offering heavy discounts on portfolio basis to retain their accounts and were quoting less than 10 to 20% below the estimated outgo in group health segment to attract new corporate. 

These corporate with loss making group health covers continue to escape price hikes by shopping for new insurers. The chase to build up top line and the pressure on marketing force of the insurers for their targets resulted in health insurers willingness to accept the business even not covering expected claim cost ignoring loading for medical inflation, acquisition cost , servicing cost by third party administrators and management expenses. 

In a bid to address this issue and to bring corporate governance in the business behaviour of rhe insurers the Authority has prescribed its pricing prescription which is applicable with the 1st day of 2015. The Authority's prescription for pricing fire, property and group health insurance is to consider Burning Cost as starting point to price these risks. This only can move market forward towards claim plus pricing mechanism. Burning cost is the estimated cost of claims in proposed insurance period and is calculated from previous year claim experience of the insurer duly adjusted for change in number of lives and for changes in the benefit design proposed for current year of the risk. IRDA in its advisory and prescription has made it very clear that industry-wide losses should be considered for pricing the product and insurers current level experience of acquisition and management expenses should be loaded to it. 

The industry-wide burning cost is available with IIB (Insurance Information Bureau of India) for Fire and Property Insurance but such industry-wide burning cost for group health is not available. The Authority is also aware that brokers are not disclosing all details of group health experience to insurers at the time of RFQ (request for quote). In health insurance the trend & incidence rate usually does not vary from year to year. However, the average claim cost bears the impact of medical inflation to some extent. Till the IIB is ready with the industry-wide Burning cost in group health segment the authority has tightened the reporting parameters. It has prescribed that the intermediary or the client will mandatory have to sign and disclose the claim cost of last year and preceding two years in the input format designed by General Insurance Council of India (GI Council). This will surely improve the disclosure and will put insurers in a better position to assess the risk on quality data necessary to price the risk.

With uniform data now available to underwriters if any of them choose to price the group health risk lower than burning cost than it will have to have the approval of its Board of Directors. Further this will have to be filed in form of Exception Report in a format to be designed by IRDA.

The Regulator has initiated this move to see right pricing coming into the market and corporate governance in the business behaviour of the insurers. The move signals that premium for this fastest growing portfolio would be rising in last quarter of 2014-15 or else there will be reduction in the benefits including caps beings introduced for procedures or else employers will seek sharing of cost from employees for present benefit design of their health protection covers.

It is a time now to watch whether the insurers will now move to a more realistic market or they are looking something else.....topline obsession.....