Introduction : Health as an asset—Health systems—Health services: Public/Private;—concept of Health financing —concept of Health insurance- Adverse Selection and Moral Hazard issues in Health insurance. Indian context - Health Financing in India and Health Systems in India.
Health financing models: Concept of Universal Coverage- Social Health Insurance and Tax-Funded Health financing schemes: Government sponsored insurance schemes; Community schemes and Micro Health Insurance. Private Voluntary Health Insurance. Health insurance in USA; UK; Switzerland; Chile; Singapore; Thailand; Brazil; China; Indonesia Health: Scope of Health Insurance Covers- Individual and Group indemnity plans—Floater PlansBenefit plans- Critical Illness plans- High Deductible plans- Comprehensive coverage plans- Long term care insurance — Travel Insurance- Micro Health Insurance—Health Insurance plans for Senior Citizens — Disease Management plans- Other Products Health Insurance Underwriting: — The underwriting process—Risk classification and analysis—
Customer Service in Health Insurance; Consumer protection and awareness in the context of Health Insurance—Customer services for Health insurance: Leveraging technology; Grievance Redressal Mechanisms: IRDA-PPI Guidelines, Grievance Cells; Ombudsman; Judicial channels; Servicing senior citizens, Issues related to Standardization of Care and Quality of Care. Regulator‘s role in Customer protection. Health Insurance Frauds: Consumer fraud—Intermediary/ employee/hospital/policyholder frauds— Detecting and investigating frauds — Anti-fraud measures. Role of Insurance Councils in Health Insurance; Life Insurance Council; General Insurance Council. Reinsurance: Health insurance and reinsurance models. Niche products supported by reinsurers.
