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Is Health Insurance Actuarially Fair? Quantifying Discrepancies in the Indian Health Insurance Sector

Author

Listed:
  • Nikhil Rathee

    (MA Actuarial Economics, Madras School of Economics)

  • Rupel Nargunam

    (corresponding author, Assistant Professor, Madras School of Economics)

Abstract

This study investigates the actuarial fairness of health insurance policies by examining discrepancies within the Indian health insurance and their impact on medical costs. By virtue of its creation, the scope of health insurance contracts is to cover medical expenses and the cost of the same is expected to reflect the expected cost of medical services. In practice it is observed that there are discrepancies such as misinformation, accessibility to health care services, hospital quality and inconsistencies in claims processing, increase costs associated with health care of individuals participating in the health insurance, which affect the fairness in pricing of these policies. This study uses Structural Equation Modelling (SEM) to develop latent variables representing these discrepancies and Hierarchical Linear Modelling (HLM) to assess their effect on the cost of medical care. The findings of this study support the presence of region-wise discrepancies in the Indian health insurance sector and the results support the significant impact on the increase in medical expenses. The study concludes with policy recommendations aimed at enhancing the efficiency, effectiveness and fairness of the health insurance policies in India.

Suggested Citation

  • Nikhil Rathee & Rupel Nargunam, 2024. "Is Health Insurance Actuarially Fair? Quantifying Discrepancies in the Indian Health Insurance Sector," Working Papers 2024-271, Madras School of Economics,Chennai,India.
    • Handle: RePEc:mad:wpaper:2024-271
    as

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    References listed on IDEAS

    as
    1. Jens Matthias Arnold & Beata Javorcik & Molly Lipscomb & Aaditya Mattoo, 2016. "Services Reform and Manufacturing Performance: Evidence from India," Economic Journal, Royal Economic Society, vol. 126(590), pages 1-39, February.
    2. Dr. Ben Kajwang PhD, 2020. "Contribution Of Industrial All Risks Insurance To The Growth Of Manufacturing Firms In Kenya," Journal of Developing Country Studies, IPRJB, vol. 5(1), pages 36-48.
    3. Zou, Hong & Adams, Mike B., 2006. "The corporate purchase of property insurance: Chinese evidence," Journal of Financial Intermediation, Elsevier, vol. 15(2), pages 165-196, April.
    4. Mário Raposo & Helena Alves & Paulo Duarte, 2009. "Dimensions of service quality and satisfaction in healthcare: a patient’s satisfaction index," Service Business, Springer;Pan-Pacific Business Association, vol. 3(1), pages 85-100, March.
    5. Fujin Zhou & Wouter Botzen, 2021. "Firm Level Evidence of Disaster Impacts on Growth in Vietnam," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 79(2), pages 277-322, June.
    6. Laureen Regan & Yeon Hur, 2007. "On the Corporate Demand for Insurance: The Case of Korean Nonfinancial Firms," Journal of Risk & Insurance, The American Risk and Insurance Association, vol. 74(4), pages 829-850, December.
    Full references (including those not matched with items on IDEAS)

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    More about this item

    Keywords

    Pricing Health Insurance; Actuarial Fairness; Discrepancies; Misinformation; Claim process inconsistencies; Access to Medical Services.;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I13 - Health, Education, and Welfare - - Health - - - Health Insurance, Public and Private
    • G22 - Financial Economics - - Financial Institutions and Services - - - Insurance; Insurance Companies; Actuarial Studies
    • G52 - Financial Economics - - Household Finance - - - Insurance

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