Session 6B Appropriate Treatment of Obesity Demonstrates Clinical & Economic Success

Transcription

1 Session 6B Appropriate Treatment of Obesity Demonstrates Clinical & Economic Success Part 1 S Prakash, MS FRCS(Glasgow) FAIS

2 Dr. S Prakash, MS, FRCS (Glasgow) FAIS Chief Operating Officer Star Health & Allied Insurance Co., Ltd., CHENNAI, INDIA SOA Asia Pacific Annual Symposium APPROPRIATE TREATMENT OF OBESITY DEMONSTRATES CLINICAL AND ECONOMIC SUCCESS Dr SP India 1

3 Table of Content STAR Insurance Overview Introduction to Metabolic Surgery Journey to Innovation Product Features Financial Results Actuarial opportunity OVERVIEW #1 private retail health insurer in India 9.33% share in the health insurance market 18.18% share in retail health insurance 42% GWP Growth FY 15 FY 17 CAGR 9.1 million lives covered ~360 years cumulative industry experience across senior management 38 products offered across the spectrum 10,000+ Employees 329 branches 636 SM stations 1,27,547 agents 8123 hospital network offering cash less facilities Backed by: Apis, ICICI, Sequoia Capital, and Tata Capital 2

4 INDUSTRY OVERVIEW: COMPETITIVE LANDSCAPE Overview of Health Insurance Providers in India Health GWP (2016) US$ Mn Pure Play Private General Public General New India United India National Oriental Star Health ICICI Lombard Apollo Munich Bajaj Allianz HDFC Reliance Max Bupa Religare IFFCO Tokio SBI General Chola MS Royal Sundaram Tata AIG Future Generali Cigna TTK Universal Sompo Bharti AXA L&T General Liberty Videocon Kotak General Raheja QBE Magma HDI Shriram General Pure play players are Gaining in popularity Health insurance GWP by segment US$ Mn 2, , , ,430 1,618 1,923 3, , Public Private Pure Play CAGR 33% 18% 5% Star Health is the biggest and fastest growing Pure play health insurance GWP US$ Mn % 49% 50% % CAGR NM% NM% 23% Star Health Apollo Munich Max Bupa Religare Cigna TTK 12% 24% Introduction to Metabolic Surgery 3

5 Introduction to Metabolic Surgery Metabolic Surgery is no longer just Bariatric Becoming thin is incidental, of greater importance is it avoids downstream complications Also, it makes them live healthy for another 15years More than a high blood sugar, it is the duration of DM Butt fat is brown and it is good. Belly fat is white fat and not so good Advantages of Metabolic Surgery Diabetics Hypertension Sleep Apnea Dyslipidemia OA Disc prolapse PCOD Infertility GERD Diabetic Vascular disease. 4

6 Bariatric in INDIA 21% of the Indians are Obese and more than 32.5% BMI is significant for Indian population No. of Centres Providing Bariatric (OSSI) 220 In the Year ,000 surgeries Most Commonly used Techniques Sleeve Gastrectomy MGB RYGB Robotics in Bariatric practiced in over 10 centres Select centres perform up to 900 surgeries per annum Product Features 11/07/2012 Eligibility General Terms Floater / Individual Cover Policy formulated on a floater basis; One policy for the entire family covers self, spouse and dependant children Eligible age spans from 18 years until 65 years Sum Insured (in Lakhs) Min 5 & Max 25 Beyond 65 years, It can be renewed for life time; Life long renewal Dependent children can be covered from 3 months and up to 25years of age Pre Existing Diseases are covered after 48months of continuous Insurance without break with any Indian Insurance Company Tax benefits under Section 80D of the Income Tax Act Coverage Basic cover In patient hospitalization Pre hospitalization medical expenses Post hospitalization medical expenses Day care procedures (101 procedures) Road ambulance cover Value added covers Maternity cover New born baby cover OPD treatment for Dental and Ophthalmic Hospital cash benefit Automatic restoration of sum insured 5

7 Journey to innovation Market Research Collation of Data Discussion with Surgical Experts Pricing and Incorporation of T & C Underwriting Guidelines Acceptance of Reinsurer Approval by Regulator Training of Sales force Feedback Post roll out Modification of 2015 : Value added covers Bariatric Surgery Air Ambulance Personal Accident cover Electronic second medical opinion 6

8 Challenges Translating the data to insured population (8% covered) Addressing antiselection Creation of sub limit Identifying Centre s of Excellence FINANCIAL RESULTS TOTAL (FY 16) TOTAL (FY 17) GROWTH RATE % Product Name NOP Premium(INR Cr) (Mn USD) NOP Premium (INR Cr) (Mn USD) NOP Premium Star Comprehensive 71, (18.9) 156, (4.23) 117% 123% 7

9 Outcome FY Premium (In Cr) Growth % (1.6mn USD) (4.6mn USD) (8.6mn USD) 85% (18.3mn USD) 113% (41mn USD) 123% Our Innovative: Industry First products Extensive range of 37 products including many industry firsts Product for Senior Citizens Top up/ Super Surplus plan Diabetes Care, catering to Diabetes Mellitus patients Cardiac Care Health + Life combination policy Products for every customer need Star Criticare with twin benefits of indemnity and lump sum payment for over 11 critical diseases Only insurer to provide coverage for HIV + persons Autism Spectrum Disorder Industry First Products 8

10 CALL TO ACTION Thanks 9