Komal Rathi

INTERN AT JYOTI MULTI SPECIALITY HOSPITALS

Functioning and importance of insurance
companies in health sector in reference
hospitals
What is health insurance ?

A health insurance policy extends coverage against

medical expenses incurred owing to accidents, illness
or injury. An individual can avail such a policy
against monthly or annual premium payments, for a
specified tenure.
Importance of health insurance :

• Health insurance covers essential health benefits critical to maintaining

your health and treating illness and accidents
• Health insurance protects you from unexpected, high medical costs
• You pay less for covered in-network health care, even before you meet
your deductible.
• You get free preventive care, like vaccines, screenings, and some
check-ups, even before you meet your deductible.
• If you have a Marketplace plan or other qualifying health
coverage through the plan year 2018, you don’t have to pay the penalty
that people without coverage must pay
Functions of health insurance

Protection and safetyThe  key function of insurance is to safeguard against the possibility of loss.
The time and amount of loss are unpredictable, and if a risk occurs, the person will incur a loss if they
do not have insurance. Insurance ensures that a loss will be paid and thereby protects the insured
from suffering. Insurance cannot prevent a risk from occurring, but it can compensate for losses
resulting  from the risk.
Provide safety and security Insurance provides financial support and decreases the risks that come
with doing business and living. It ensures safety and security in the event of a specific incident. The
basic function of insurance is to safeguard against future hazards, accidents, and vulnerabilities in this
way.

Certainty of payment Insurance gives payment certainty in the event of a loss. Better planning and
administration can help to lessen the risk of loss. In risk, there are various sorts of uncertainty. In other
words, the occurrence of time and the amount of loss are both unpredictable. All of these concerns
are removed through insurance, and the insured is guaranteed money in the event of a loss.
Is a patient in hospital a customer or a
patient ? How important is hospitality in a
hospital.
 A “customer” is a person or entity that obtains a service or product from
another person or entity in exchange for money.  Customers can buy either
goods or services.
 A patient is any recipient o healthcare services that re performed by
healthcare professionals. The patient is most often ill or injured and in
need of treatment by a physician, nurse, dentist or optometrist.
Patient can’t be a customer because :

 Patients are not on vacation.  They are not in the mindset that they are
sitting in the doctors office or the hospital to have a good time.  They are not
relaxed, they have not left their troubles temporarily behind them.  They have
not bought room service and a massage. They are not in the mood to be happy. 
They would rather not be requiring the service they are requesting.  Which leads
to number 2:
 2. Patients have not chosen to buy the service.  Patients have been forced
to seek the service, in most cases.
 3. Patients are not paying for the service.  At least not directly.  And they
have no idea what the price is anyway.
 4. Patients are not buying a product from which they can demand a
positive outcome.  Sometimes the result of the service is still illness and/or
death.  This does not mean the service provided was not a good one.
How important is hospitality in a hospital?

 As the healthcare field becomes increasingly competitive, medical

practitioners need to offer a service that meets the high standard of
service expected of them. With the ability to compare services and
read customer testimonials online these days, patients have greater
freedom to choose a healthcare provider.

In an environment such as a hospital, a patient can quickly feel
depersonalized, so it is important to add the element of human touch
to help them feel comfortable and seen at every stage of their stay.