Insurance companies will have to mandatorily refund excess premium if the claim ratio turns out to be less than 85 per cent under the Centre’s ambitious ‘National Health Protection Mission’ (NHPM), according to a proposal by the Union Health Ministry. The programme will provide a coverage of Rs 5 lakh to 10 crore poorest families of the country.
For example, if the premium paid by the government is Rs 100, and the average claim per family is only Rs 50, the insurance company will refund Rs 35 to the government, said a senior official from the Ministry.
The proposal was discussed by the Health Ministry during consultations with representatives from leading general and stand alone health insurance companies, and private hospitals on Wednesday.