StartupTalky

Tag: Health Insurance

  • Is Even Really Disrupting The Healthcare Insurance Industry?

    The Indian insurance industry has witnessed significant progress with both life and non-life insurance growing at a CAGR of 17% and 14% respectively in the past five years, according to a BCG report. The total number of lives covered in this period has doubled from 12 crores to 23 crores.

    Although the Indian insurance market is underpenetrated as compared to the global leaders such as the United States. There is a lot of scope for growth and with the outbreak of Covid-19, there has been a major change in the perception of Indian consumers regarding the awareness of their health and the requirement of a health insurance policy.

    The Demand for the Insurtech Industry
    Insights of the Insurtech Industry
    About Even
    Is Even Really Disrupting The Healthcare Insurance Industry?

    The Demand for the Insurtech Industry

    The pandemic paranoia has led to a near 7% increase in the intent to buy insurance globally. Moreover, research by “The World Insurtech Report, 2021” by Capgemini, stated that around 50% of the customers today are willing to consider insurance coverage from a new age player (insurtech startup).

    This clearly states that the demand for the insurtech industry is rising globally and India is also witnessing the same trend. Not only from the consumer perspective, but even the investors’ are also betting more in this industry. The insurtech startups in India raised $822 million in 2021 which was 166% higher than the previous year.

    Driven by the shift in the mindsets of the people for insurance products after the pandemic, simplified processes by the digital insurance players, low premium insurance offerings and increased investors’ interest, the insurtech industry in India is expected to reach $339 Bn by 2025.

    Expected Growth of Insuretch Industry in India
    Expected Growth of Insuretch Industry in India

    Insurance Sector In India
    Here’s a brief overview of the Insurance sector in India along with its market size, industry challenges, government initiatives & future.
    StartupTalkyDevashish Shrivastava

    Insights of the Insurtech Industry

    Insurtech industry is in the growing phase post-Covid, with the existence of more than 110 insurtech players in the country. All these players are focused on offering not only the common life insurance offerings but also non-life insurance covering health, education, vehicle and other areas.

    The focus on health insurance has risen post-pandemic with the rise in the health awareness of the people. Thus, it has been the major focus of most insurtech’s as well as healthtech startups.

    About Even

    Startup Name Even
    Founded 2020
    Founders Mayank Banerjee, Matilde Giglio, and Alessandro Davide Lalongo
    Funding Raised $5 million
    Key Investors Khosla Ventures, Founders Fund (led by Peter Thiel), Lachy Groom, Kunal Shah, and Nikesh Arora
    Business Model B2b-B2C
    Primary Competition Kenko
    User Base 40+ Users on the Waitlist

    Even, a Bengaluru-based healthtech startup, founded in April 2020 by Mayank Banerjee, Matilde Giglio, and Alessandro Davide Lalongo, is a healthcare membership company that partners directly with the top hospitals to provide fully-cashless and quality healthcare accessible to its members.

    It is currently operational only in Bengaluru. The company claims that anyone who opts for being its member can avail of unlimited consultations and diagnostics, also a hospitalisation cover of 50 lakhs annually.

    It has tied up with major hospital chains such as Fortis and Narayana Health. The company currently has 40K+ applicants on the waitlist and has plans to reach more than 1 lac users in major cities such as Delhi, Mumbai and Bengaluru.

    Covid-19 not just accelerated IPD (In-patient department) but also accelerated the demand for OPD (Out-patient department) including regular doctor consultations and check-ups not requiring hospitalisation of the patient. The OPD market is expected to reach $37.5 billion by FY2024, according to research by Praxis Global Alliance.

    Most health insurance companies usually don’t cover OPD expenses and the ones which cover it have immense paperwork and tiresome process, that’s where Even wants to position itself. It wants to bridge the gap and make healthcare easily accessible with its partner network.

    Although the company claims to be a subscription-based healthcare service provider, it compares itself with the other health insurance providers. Let us actually compare its offering with other insurance providers and see how better it is than theirs. Let’s look at the table below to understand how Even fairs compared to other insurance providers.

    Even Vs Other Insurance Providers: Which Is Better?

    Parameters Even Other Insurance Companies
    OPD Yes Yes
    Price High Low
    Starts from Day1 Yes No
    Exclusion of Existing Disease Yes Yes
    Cashless Yes Yes
    Hospital Network 21+ 2k-16k
    Initial Waiting Period 0 Days 30 Days
    Co-Pay 0 10-30%
    Age Limit 0-64 years 5-80 years
    Minimum Term 3 months NA
    Cover 50 Lakh a year 5 Lakhs a year

    Is Even Really Disrupting The Healthcare Insurance Industry?

    It is clearly evident from the comparison table that Even is offering sort of similar or even fewer benefits as compared to health insurance at a higher price. Not only this, it excludes a lot of benefits in its membership which are otherwise included in the other health insurance companies such as Maternity care, Home health care, and AYUSH treatment.

    When we reached out to the customer care executive of Even, they themselves were not clear about what is included and excluded in the membership and had to reconfirm with other team members.

    The major issue with Even is that it currently has a very small partner hospital network of only 21 hospitals so the benefits of the membership can only be availed in those hospitals and although it claims that it can make possible the out of network emergency care (emergency care for members if they are outside Bengaluru), how much of it is actually possible still remains a question.

    Although there is immense potential in the insurtech industry and hence, a lot of players are entering the market since public money and health is involved in it, these players will remain under the regulator’s purview. There are chances that a lot of such players may run into conflict with IRDAI (Insurance Regulatory and Development Authority Of India) rules.

    Even has a clinical establishment licence from Karnataka Government, it has partnered with Cholamandalam MS General Insurance to offer a hospitalisation expense coverage ranging from ₹5 Lacs to up to ₹50 Lacs in its premium (Even Plus) plan which comes under the group policy with the insurer.

    Thus, we see that Even and other such health subscription startups buy group health plans from the insurer and onboard retail users and add them later as policy members. Thus, the insurer is underwriting the company and later underwrites the retail customer, but if in case the company faces any issue, the customer may not have anyone to go to for claiming its subscription.

    Conclusion

    Even though the model of health subscription is aimed to ease the process for the customers and seems intriguing, it is yet to be discovered how these subscription-based healthcare startups such as Even will sustain in the long term given the ambiguity in the regulations and highly unorganised nature of OPD market in the country which may lead to the higher risks of frauds for them.

    FAQs

    What is Even?

    Even is a healthcare startup that provides cashless and unlimited OPD insurance health cover.

    Who are the founders of Even?

    Even was founded by Mayank Banerjee, Matilde Giglio, and Alessandro Davide Ialongo.

    Which health insurance has the highest hospital network?

    Care Health Insurance Limited has the highest hospital network. It has more than 16,500 network hospitals across India.

  • HealthySure – Employee Welfare Insurtech PLatform

    Company Profile is an initiative by StartupTalky to publish verified information on different startups and organizations. The content in this post has been approved by HealthySure.

    Awareness towards health has increased after the Covid-19 pandemic. People have seen a medical crisis during pandemics which has made them more concerned about health insurance. The increase in awareness and demand for health insurance has confirmed that consumers want better health insurance for themselves and their families. Even after opting for good coverage, when in need, claiming health insurance becomes a pain point for consumers.

    HealthySure has brought a solution through its affordable and accessible healthcare insurance system. It enables Indian citizenship to get a healthy society through insurance along with healthcare services. Read to know more about HealthySure, its founders, business model, its services, and the startup story.

    HealthySure – Company Highlights

    Startup Name HealthySure
    Headquarters Mumbai
    Industry InsurTech
    Founders Sanil Basutkar & Anuj Parekh
    Founded 2021
    Total Funding Raised INR 9 Crores
    Website healthySure.in

    HealthySure – About
    HealthySure – Industry
    HealthySure – Founders and Team
    HealthySure – The Idea and Startup Story
    HealthySure – Name, Tagline, and Logo
    HealthySure – Products and Services
    HealthySure – Business Model and Revenue Model
    HealthySure – Customer Acquisition
    HealthySure – Challenges Faced
    HealthySure – Growth
    HealthySure – Funding
    HealthySure – Competitors
    HealthySure – Tools Used in the Company
    HealthySure – Future Plans

    Anuj Parekh, co-founder of HealthySure sharing story of starting HealthySure

    HealthySure – About

    HealthySure is an employee welfare insurtech. They offer 360-degree insurance and healthcare for organizations and their workforce. Their ultimate vision is to enable affordable and accessible healthcare to the Indian population, and they see organization sponsored health programs going a long way to achieve that.

    Even if an organization is spending a small amount to get insurance cover for their workforce, they plan to leverage that spend and let employees take advantage bring down the cost of comprehensive voluntary health insurance.

    They genuinely believe that a lot can be done to improve healthcare in the country and they hope to play a big part in the coming years to help achieve that.

    HealthySure – Industry

    The Group Health Insurance Market is projected to grow to $11Bn (Rs 80,000 Crore) by 2025 and is almost 1.5x the size of the retail health market. (IRDA Industry Statistics and IBEF and Mordor Intelligence reports). These numbers were projected pre-pandemic. They have clearly seen that this number will be way higher due to the increasing awareness and necessity of health insurance post-covid.

    There are more than 100 million private organizations in India. As India’s penetration of insurance and health cover is very low, there is a huge scope for social security to be provided through organizations as is the case with some of the developed countries. HealthySure is focusing on SMEs and corporates in India with 1 Million such businesses, employing 36 million people.

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    HealthySure – Founders and Team

    HealthySure Founders – Sanil Basutkar & Anuj Parekh

    Anuj is the Co-founder and CEO. He is a chartered accountant and a national rank holder, and has graduated from IIM Bangalore. He has over 7+ years of experience in management consulting, investment banking and corporate finance. Anuj was the key project consultant at Virgin Hyperloop, driving commercialization of world’s first hyperloop corridor in India before taking the plunge into entrepreneurship.

    Sanil is the Co-founder and Product Head. He is a chartered accountant and has graduated from Indian School of Business. He has 7+ years of experience in product management, financial services and management consulting. He is also a founder of Saransh app, a news-in-short equivalent for the vernacular masses. Sanil was the lead product manager at Torre Capital, a fintech investments platform before co-founding HealthySure.

    They are very good friends from their undergrad days when they studied at N.M. College. They always wanted to solve problems, create an impact and had an entrepreneurial mindset. The problem that they are solving, they could personally relate to which just gave them the push to launch HealthySure.

    They bring in complimenting set of skills – while Anuj handles sales, business development and operations, Sanil is involved in product, technology and marketing. Rest of the functions are pretty much divided between the rest of us. Their experience working with startups has really helped us manage multiple things within the company.

    They are currently a team of 25+. They have set up a culture that promotes ownership and responsibility. They encourage team to be not afraid to make mistakes and solve problems on their own. They like to offer a helping hand to them wherever needed. While they promote their openings across, they generally speak to people who directly approach them and also heavily promote referrals within their team and network.

    HealthySure – The Idea and Startup Story

    It was during, the pandemic that they observed a big problem faced by people even with a health insurance cover. For some of their close friends, COVID hospitalization costs for family members were going through the roof. Despite having organization-sponsored health insurance, they were struggling to pay off bills as their cover was inadequate or had certain restrictions such as a room or disease capping leading to short claim settlements.

    As they dug deeper into this problem, this pattern of inadequate health cover was clearly visible across the board.

    Organizations, in most cases, are restricted by budget constraints and as a result opt for a cover that may not be comprehensive. For instance, a corporate health cover of 3 lacs may not be enough to cover healthcare needs of an employee’s family and this does not inspire confidence. This results in either the employee opting for a separate personal cover and in essence paying double the premium or as in most cases, the employee is unable to afford a comprehensive cover, thereby leaving him with the potential for crippling debt at the time of critical emergencies – as was the case observed during COVID. It’s not that people don’t want to have a comprehensive cover, health insurance is also becoming an expensive proposition for many.

    They have innovated a first-in-industry product that helps employees upgrade their corporate health cover for a nominal amount. In the process, the employees enjoy saving as high as 90% over an independent policy. The employees get an added advantage of continuing such covers in personal capacity post-employment with HealthySure. HealthySure is thus making it very affordable to have a comprehensive lifelong insurance cover for any employee.

    HealthySure Logo
    HealthySure Logo

    HealthySure is a unique combination of belief in enabling a healthy society and primarily enabling it through insurance along with healthcare services. So, it’s basically a blend of Health + Insure. Their close friends pitched in with the suggestion while they were brainstorming on what to call ourselves. They immediately identified with it. Their logo is just an extension of their name and identity.

    HealthySure – Products and Services

    HealthySure provides group health insurance to companies. They have innovated a first-in-industry product that helps employees upgrade their corporate health cover for a nominal amount. In the process, the employees enjoy saving as high as 90% over an independent policy. The employees get an added advantage of continuing such covers in personal capacity post-employment with HealthySure. They are thus making it very affordable to have a comprehensive lifelong insurance cover for any employee.

    HealthySure offers employees to take a cover of as high as Rs. 1 crore and all this, while saving significant costs since a sizable portion is subsidized by the organizations themselves. All this is managed through a seamless tech experience for the organization and as well as their workforce.

    The platform also offers a 360 degree healthcare services for their clients including doctor consultations, health checkups, mental wellness, fitness memberships, discounted pharmacy purchases and lab tests among a few.

    They operate in the B2B space and are also able to target employees and have a B2B2C segment. Insurance plans may cost as little as Rs 50 per employee per month for basic covers and can go as high as Rs 3,000 per employee per month for a comprehensive coverage. Compared to retail covers in the market, this still comes at a very low cost.

    HealthySure – Business Model and Revenue Model

    HealthySure monetizes through insurance commissions and selling healthcare services to organizations. Due to their unique offering of Unified Health Insurance, they also see good demand from employees subscribing to additional voluntary insurance coverage.

    HealthySure – Customer Acquisition

    Getting the first set of customers is always a challenge for any business, specially if you are a B2B business. What worked in their favor was their narrative of ensuring the best possible service and addressing the pain points of their customers.

    As the market grew, they started automating their processes and thus letting them gradually build scale. To give an example, they carefully studied the health insurance claims journey of an employee. In a few months, they automated the entire backend process for their customers. They were careful not to bring in the usual solutions of chatbots and telecallers as they understand that human element is always critical in a stressful time like hospitalization. Their clients therefore always have a person to talk to which gives them comfort.  As a result, they have settled more than 100+ claims and have received 5 star ratings from their customers on the service.

    HealthySure – Challenges Faced

    For any startup, building a team and fostering a great culture is the biggest challenge, even more than raising capital. They have been lucky to have had great people in the founding team, who have believed in their vision and continue to deliver exceptionally.

    Building their team required great efforts. While it is important to build a team as soon as possible, they would generally take time. They spoke to people who approached them directly or through their networks and build a connect with them. So even if their team building took time, they had the best of people join them who believed in them and their vision. They have managed to keep their attrition really low which has given them a good stability to build the company.

    Their culture of emphasizing learning, ownership, and responsibility ensures that they are building leaders within the company. This is something that will be their competitive advantage for years to come.

    HealthySure – Growth

    HealthySure started operations 9 months ago and currently doing an Annualized Gross premium of around 15 Crores. This is additionally supplemented by revenue from healthcare-related services. They expect this to grow significantly. They are scaling up their team, technology and operations. While they are yet to achieve profitability, they are confident it may come within the next 2-3 years. They have been very efficient in capital deployment and will focus on growth as well as profitability.

    HealthySure – Funding

    Date Stage Amount Investors
    Feb 2022 Pre-series A INR 9 Crores

    They have raised a pre-series A round funding of Rs. 9 crores in Feb-22 with a clutch of institutions participating. The funds are currently being deployed to scale up their tech, operations and to create an amazing brand HealthySure.

    HealthySure – Competitors

    Some top competitors of HealthySure are:

    • Pazcare
    • Nova Benefits
    • Plum

    HealthySure – Tools Used in the Company

    Some of the tools that HealthySure uses to run the startups are:

    HealthySure – Future Plans

    They hope to serve around 1,50,000 lives within the next 12 months and over a million over the next 2 to 3 years. They have aggressive plans to build a brand that the entire B2B ecosystem has trust and confidence with. Their target groups are SMEs in India, who are predominantly looking to buy employee benefits for the first time. They see a lot of growth in this sector as organizations realize the importance of health covers post the pandemic. There are also some indications of government mandating employee health covers as social security for organizations like certain developed countries. If this happens, it will give rise to exponential demand.

    FAQs

    When was HealthySure founded?

    HealthySure was founded in 2021.

    Who is the founder of HealthySure?

    Sanil Basutkar & Anuj Parekh are the founders of HealthySure.

    Is HealthySure funded?

    Yes, HealthySure received a funding of INR 9 Crores in Feb 2022.

  • Importance of Standardization and Centralisation of Resources to Tackle the Medical Needs of Society

    The article is contributed by Karan Gupta, COO & Co-founder of Ayu Health Hospitals

    As an entrepreneur, finding solutions to real-world problems has always been my calling. There is a visible opportunity to do so in the area of the Indian healthcare system. While the overall healthcare infrastructure across the country has also developed during the pandemic there is a lot more that can be done to cater to the middle-class population of the country which arguably forms the largest percentage of the population.

    The latest “Healthy States, Progressive India” report by National Institution for Transforming India (NITI Aayog) showcased state-wise ‘Health Index’ for Indian states and union territories. The report provided insights on the health outcomes, governance and information, and key inputs and processes involved. The summary of the report showed that among the larger states – Kerala, Tamil Nadu, and Telangana were considered as the best performers. However, it should also be noted that 50 percent of larger states did not even reach the halfway mark in terms of the ‘Composite Index Score’ for overall performance.  The report also clearly showcased that there is a clear disparity between urban and rural healthcare as well as a difference in the quality of healthcare provided by the private and state healthcare facilities. A few areas of opportunity that could improve the healthcare system and bridge these gaps are:

    Building Awareness

    A large part of the country has people who are unaware of the importance of regular health check-ups. Currently, people visit the hospital only once in a couple of years when they notice a condition. By the time they notice it, the condition might have worsened. Educating them about the benefits of regular checkups to preempt the condition from worsening is important.

    Access to Healthcare

    Having a healthcare facility that can provide all the necessary treatments as well as diagnostic and medication support at a short distance from one’s residence is the need of the hour. Such a facility will provide regular care to the people in that locality resulting in a highly productive workforce that will, in turn, add to the growth of that locality.

    Healthcare Staff

    Adequately trained doctors, nurses, and technicians are a necessity for every healthcare facility to become successful. Such well-trained healthcare staff should also be supported by additional members who manage and maintain all the non-medical aspects of the hospital including – administration, procurement, logistics, etc.

    Affordability and Pricing Transparency

    Multiple reports show that 75% of the people in the country don’t have medical insurance and have to pay for healthcare from their pockets. One of the main reasons for the general public’s distrust in private hospitals is the contrast of the amount that one needs to pay at the end of treatment vis a vis the amount quoted by the hospital before the procedure. Added to this is the difference in pricing that is provided to insured vs. uninsured patients, which is further followed by the fluctuations in pricing based on the availability of facilities and seasonality of the disease. Providing clear costs upfront to the patients will help in preparing the patient’s family for making an informed decision about the options that they have.

    Confidence to Make a Pragmatic Choice

    The internet, friends and family, doctors- are all sources from which people get information about their condition and the route they should take to cure themselves. However, the amount of information and the difference in the advice from each of the sources makes it difficult to decide between treatments, hospitals and doctors. Standardizing the right information about the condition, course of treatment, price, infrastructure, and the facility to avail themselves of second, third, fourth, as many doctor opinions as they need to decide on the right way forward would empower people to make the right choice with confidence.

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    Conclusion

    Many of these problems in the current healthcare system can be solved with the help of technology that can standardize treatment protocols and centralise resources. With the points listed above, the healthcare setup in the country can attempt to solve many of the discrepancies through standardisation of care resulting in consistent health outcomes. This will further build better awareness amongst the patients and caregivers. Patients have the right to gather all the relevant information throughout their in-patient journey. Such transparency will rebuild the public’s trust in the healthcare system of the country and will also provide them with all the necessary information that they may need regarding the treatment options that are available to them and the most affordable price that they will have to pay for it.