“ADITI” Narayana Health Insurance Plan – First Look

by | Jul 16, 2024

Narayana Health Insurance, a wholly owned subsidiary of Narayana Health launched its first health insurance plan named ADITI earlier this month. This health insurance plan received a lot of media and public attention upon its launch due to two reasons.

First, it proposes to provide Rs. 1 Cr cover for just Rs. 10,000 a year for a family of 4 where the eldest member is aged 45 or less. 

Second, Aditi is launched by Narayana Health Insurance which has its own network of hospitals under Narayana Health. This implies that there will be no more conflict of interest between the insurer and the treating hospital leading to near zero claim rejections.

But what are the challenges beneath this enticing offer Aditi health insurance makes? What are the caveats which people have to keep in mind before considering this health insurance plan? Let’s get into the fine print of this product and find out the answers to these questions.

Aditi Health Insurance Benefits

Aditi Health cover offers 2 major benefits. Rs. 1 Cr. health cover for major surgeries and Rs. 5 Lakh cover for other medical treatments at Narayana Health hospitals. All this comes at a cost of just Rs. 10,000 per year for a family of 4. The plan also proposes to provide discounted diagnostic tests to those armed with this health insurance plan in its network hospital. 

When health insurance premiums are on the rise, Aditi health insurance comes with an offer which certainly looks irresistible. The plan tries to bring the middle and lower middle working class under the ambit of health insurance by bringing it at an affordable rate. With this proposition, Narayana Health Insurance with its first health insurance plan, Aditi, has its heart at the right place.

The Captive Health Insurer

Health insurance usually comes with a conflict between the insurer and the healthcare provider. While the treating hospital tries to make the most from patients with health insurance cover by squeezing and overcharging them, the insurer wants to underpay for the same treatment to save costs. 

Narayana Health Insurance tries to bridge this gap as it is a wholly owned subsidiary of Narayana Health, a reputed healthcare provider in the country. When someone with “ADITI” Narayana Health Cover goes for a treatment in a Narayana Health Hospital, the hospital has full control over the cost of treatment. Hence it can afford to charge lower premiums and ensure near zero claim rejections.

The Problem Areas

Narayana Health currently owns just 20 to 25 hospitals across the country with major concentration in Karnataka. But people going to take any major treatment in a hospital always want to pick a doctor or surgeon of their choice based on the doctor’s past experience. This is a big limiting factor for a policyholder wanting to take treatment in his preferred doctor who might not be working in any of these limited number of hospitals. 

Rs. 1 Cr. cover is only limited to major surgeries. But surgery is not the remedy for all ailments. For other medical treatments, the ADITI cover is capped at Rs. 5 Lakh which is not good enough for a family of 4 living in a big city. The hospital chain might also face an influx of patients wanting to opt for surgery at the drop of a hat.

The Way Ahead

The hospital owned health insurance provider concept is not new. In fact, it is quite common in western countries like the US where big chains of hospitals run their own insurance companies. In India too, Apollo Hospitals tried to do the same with Apollo Munich Health Insurance but later sold its stake in the insurance company to HDFC. Hence Apollo Munich Health Insurance merged with HDFC Ergo General Insurance. 

A hospital’s core competency lies in providing healthcare services. Insurance is a very complex and a different business. Surely, some synergy lies in combining healthcare and health insurance businesses. But we are yet to see how Narayana Health does that with ADITI Health Insurance plan.

Currently the product, Aditi, is launched on a pilot basis only in four districts in and around Mysuru region. How does it unfold when it is available for anyone living anywhere in the country? How does Narayana Health counter the problem of a very limited number of network hospitals? Does it go ahead like a full fledged health insurer having tie-ups with several other hospitals? Well, in that case, it loses its major advantage of owning its network hospitals which allows it to have full control over the cost of treatment.

We will have to wait and watch.

 

Author

  • Nidhi Verma

    Nidhi Verma is the founder and CEO of Algates Insurance. Before founding Algates Insurance, she worked with India’s leading life insurance company, SBI Life, and world’s leading reinsurer, Swiss Re. She is a part-qualified actuary.

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Author Profile

Nidhi Verma - Founder & CEO at Algates Insurance
Nidhi Verma is the founder and CEO of Algates Insurance. Before founding Algates Insurance, she worked with India’s leading life insurance company, SBI Life, and world’s leading reinsurer, Swiss Re. She is a part-qualified actuary.

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Disclaimer :The information contained in this blog is for information purposes only. It does not constitute insurance advice and we do not guarantee the accuracy, adequacy or the completeness of the information contained here.

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4 Comments

  1. Kota Ramesh Babu

    Your network hosipatels in vijayawada

    Reply
    • Nidhi Verma

      Currently, ADITI network hospitals are operational in 4 districts of Mysuru region.

      Reply
  2. HONNEGOWDA

    Health insurance

    Reply
    • Nidhi Verma

      Yes, it is a health insurance plan, which is currently operation in 4 districts in Mysore region.

      Reply

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