Mumbai, February 25: Sedgwick Parekh Health Management, a joint venture consultancy of the -- 960.3 million European consulting and insurance broking group, Sedgwick, is working on a unique corporate health insurance plan in alliance with The Oriental Insurance Company. The proposed scheme, which has yet to receive an official nod, is expected to do away with certain "exclusions" criteria normally applicable in such policies.In an exclusive interview with The Financial Express, Sedgwick Parekh managing director, Nimish R Parekh, said that the new scheme is essentially based on the criteria that most corporates are healthy, and that the majority of healthy employees in a large group can subsidise the rest.In other words there will be "no adverse selection against underwriters".
Current Mediclaim (hospitalisation and domicliary hospitalisation benefit) policies include certain exclusion criteria whereby the insurance company is not liable to make any payment under this policy in respect of certainstipulated criteria.
These criteria include expenses incurred by the insured towards all diseases/injuries which are pre-existing when the cover incepts for the first time.
The new scheme, besides being more attractively priced, would also combine the benefits of credit on hospitalisation fees. Sedgwick Parekh already has alliances with over 50 leading hospitals all over the country, facilitating priority admissions, credit facilities and emergency services. These hospital bills are directly borne by Sedgwick Parekh, who in turn bills the client for the services rendered. Sedgwick merely charges a nominal non-interest bearing, refundable deposit to access such credit facilities.Key hospitals accessible by Sedgwick clients include Mumbai's Jaslok and Breach Candy hospital, Delhi-based Indraprastha Apollo hospital, Chennai's Malar hospital and Apollo Hospitals Enterprise among others.
Sedgwick Parekh, besides providing corporate advisory service to companies in management of their corporate andindividual healthcare needs, are also specialists in occupational health screening and risk management procedures.
The joint venture's client-list includes almost all top-notch corporates including Microsoft Corporation and Coca-Cola.
Parekh said that all existing clients will be given the option ofconverting their existing policies to the newone.
"Since we essentially consider age profile and pre-existing conditions in such policies, in cases where the age profile is higher, the loading can be as high as 30 per cent while in a younger group, the loading could be as low as five to 10 per cent," he said.
Asked about the mandatory clearances required to float such a scheme, Parekh said that the General Insurance Corporation of India (GIC) had given its subsidiaries full freedom to modify group mediclaim policies for their corporate clients without any tax clearances from the Central Bureau of Direct Taxes (CBDT). Official clearances for the new scheme are, however, yet to be received.
"Somecorporate clients had sought such changes and Oriental has responded effectively," he said.Parekh added that the vast amount of pharmaceutical and disease data available at the firm is also used by it to negotiate better and offer more cost-effective services at provider organisations for the employer and employees.
Copyright(c)1998 Indian Express Newspapers (Bombay) Ltd.
