How Wellness Programs Are Changing The Health Insurance Sector?


Wellness initiatives are creating a buzz in today’s fast paced life. However, many people misunderstand wellness as ‘absence of illness’. However, wellness is more than that. It primarily focuses on the good health so that your body functions more efficiently and for a longer duration than normal. Therefore, a wellness initiative is a conscious and proactive choice towards good health.

Run for Fitness
Run for Fitness

In the last few years, there has been a spurt in the promotion of health and preventive measures. Even Indian government has been actively promoting healthy living choices like Yoga and Ayurveda. The fact is that most of the health issues stem from wrong choices and ignorance. To encourage healthy living style, now health insurance companies have started offering wellness programs and initiatives to policyholders. While basic health insurance plans cover hospitalisation expenses only, increasingly insurers have expanded their health insurance plans to offer a much wider coverage.

Wellness programs are now a part of your health insurance policies

Hitting the gym every other day, quitting smoking or working out in the backyard was never as rewarding as it has become now. Given that stress and irregular working hours can aggravate any ailment, insurance companies have started wondering if they’re doing a service or disservice.

Insurance Policy
Insurance Policy

To keep things discreet, various health insurance companies have tied up with gymnastics, doctors, dieticians and fitness consultants to ensure that policyholders tread on a fitness road without fail. After all, the last thing that someone with diabetes wants is a company representative to leap out from the curtain and exclaim, “don’t eat that rasgulla!” Therefore, these insurers are indirectly rewarding policyholders for making healthy living choices.

They incentivise you to stay healthy and active by doling out incentives. The steps come in the wake of the notification issued by the Insurance Regulatory and Development Authority of India (IRDAI) who asked insurers to reward those policyholders who took good care of their health.

“General insurers and health insurers may devise mechanisms or incentives to reward policyholders for early entry, continued renewals (wherever applicable), favourable claims experience, preventive and wellness habits, etc.” as per the insurance regulator.

Why should you opt for wellness programs

Lifestyle ailments are on the rise both in urban and rural areas. Every year, roughly 5.8 million people die from heart issues, lung diseases, stroke, and diabetes. In 2015, 3,46,000 people died of diabetes, which caused 3.3% of all deaths in the year.

Health Report - The Times of India
Source: The Times of India

A large percentage of heart diseases can be attributed to factors, like unhealthy eating habits, sedentary lifestyle, and genetic predisposition. In most of the cases, diseases can be controlled or prevented by making a small yet significant change in lifestyle.

What are the benefits of a wellness program?

With a wellness program, you can enjoy the following benefits:

Healthy mind and body: By following good living habits, you can keep your mind and body healthy. These habits can be either disease-centric or lifestyle-centric. Lifestyle-centric focuses on preventive care measures like yoga or gym. On the other hand, disease management helps in dealing with chronic and pre-existing ailments, like periodic heart screening, etc.

Low premium rates: Insurers reduce premium rates of those policyholders who have adopted healthy living habits.

Early detection of health risks: Taking up medical tests frequently can detect health issues at an early stage.

Available with all types of health plans: These wellness programs are offered with both comprehensive health insurance and super top-up plans.

Which activities are covered under wellness programs?

Wellness Programs Chart
Wellness Programs Chart

How can you redeem wellness points?

Insurers are offering discounts on the basis of fitness and wellness criteria. Healthy habits like walking, running, yoga, swimming, etc. help in accumulating health reward points, which are then translated into lower premium rates.

This proves to be a game changer. For insurance, companies were earlier offering discounts only on the basis of No Claim Bonus (NCB) to policyholders who haven’t claimed in the previous claim year. With a wellness program, now a policyholder is eligible to get reimbursement of miscellaneous medical expenses which are not covered under the policy, like:

• Consultation charges
• Diagnostic expenses
• Medicine and drugs
• Dental expenses
• Wellness and preventive care

While such wellness programs and measures are not new to global policyholders across Australia, UK and the USA, Indians would be able to cut premium rates for the first time by following a healthy lifestyle.

However, in order to ensure that insurance companies do not go overboard with rewards, IRDAI has barred them from offering discounts on any third-party service. Instead of this, they can opt to give discounts on premium rates and benefits on diagnostics or pharmaceuticals.

Yoga for Good Health
Yoga for Good Health

Every Step Counts

Indian health insurance sector is in the throes of a massive transition. Wellness incentives would encourage more people to take up a healthy living style which would be useful for insurers as they may receive a fewer number of claims. Moreover, people who shun the idea of buying health insurance because they are in a good state of health should buy it. It will help them in getting the policy at low premium rates and they can enjoy wellness benefits as well. Overall, it is a win-win situation for both the insurer and the policyholder. It is, therefore, indispensable that customers look beyond premiums and look for comprehensive health insurance plans with added features. While wellness programs will help in reducing premiums, they will curtail out-of-pocket health care expenses as well.