Why It Is Important To Manage Risks In Health Care Insurance?

By Roberta Broyles

In order to better understand the importance of risk management in the health care insurance sector we will firstly understand how medical insurance works. Medical insurance as the term tells us means the insurance that we need to pay to care for our health. Under this cover of insurance the company is liable to pay us all the costs arising as a result of medical expenses. This term sometimes also includes all expenses arising from disability and long term nursing needs too.

Health care insurance is provided by many different private companies. The government also provides medical insurance to many. For getting any insurance, an individual needs to pay a fixed amount of money from time to time to the insurance company. If during the time period for which the money has been paid, the insured is afflicted due to some medical condition, then the insurance company will have to pay the costs arising out of such a circumstance to the insured.

If the insured falls ill during this time period, then the health care insurance company is liable to pay insurance money to the insured. Premium is the money that the insured has to pay in regular intervals to continue with the existing health policy.

There is a fixed amount of money that the insured needs to pay to the insurance company before he or she can stake a claim with the insurance company. This amount is called as the deductible. Coverage limit is the maximum amount of money that the insurance company is ready to pay the insured in case the insured falls ill.

The amount of money that a person pays as a premium is very small as compared to the total coverage limit that the insurance policy provides. This is why the company needs to be able to manage its risks very effectively to be able to flourish in the insurance industry.

An insurance company makes health checks mandatory for people who want a health care insurance. This is the first form of risk management, in which they try to avoid risk by not giving an insurance policy to unhealthy people.

The premium that the insurer needs to pay every month or every year depends on these checks. An older person for example might have to pay a higher insurance premium as compared to a younger person as the older person has a greater chance of getting ill and hence applying for medical cover.

Risk management is the survival mantra for all health care insurance companies. A medical insurance company having the best risk management strategies in place is the one that flourishes best. - 26221

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