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Why an Insurance Broker ?

Ethika media

As an Insurance Broker specializing in Employee Benefits Management,
some of the common complaints from Human Resource Managers,
we meet, include

"We do not see a proportionate
impact of our investment on our
Group Health Policy; our
Employee engagement budget is
about 1/3rd and yet the benefits
seem apparent. "

" The only Employees who don't
seem to have any issue with the
policy are either ones who don't
seem to recollect that they are
contributing towards the premium
payment, or ones with ageing
parents who recognize they
cannot get a cheaper deal. "

" The ones who are aware of their
contribution aren't very happy with
the deduction from their salaries,
however meagre it is. "

" Our renewal premiums have
been constantly rising - neither is
the Management happy about
it, nor are the Employees. "

" A deduction of 1000 on a claim
settlement of 100000, still has
Employees walking up to us angry
and demanding a reimbursement of
the 1000. "

Agreed Human Resource Management is a thankless job, but that doesn't
mean your insurance woes should keep propounding year on year.


A good Insurance Broker can help you underwrite a good policy
and resolve at least your insurance related problems.


Why should you hire an Insurance Broker
for your Group Health Insurance ?

Amongst the various channels for distribution of health insurance policies, Insurance Brokers contributed a share of 45% of the total group health insurance premium sourced for the year 2020-21. This statistic is cognizant of the fact of the growing trust that Customers bestow on an Insurance Broker for their Group Health Insurance policies. The Group Health Insurance policies can be created as per the requirements of the customer and therefore require a high level of understanding of the product which is where the Insurance Broker comes into picture.
In Group Health Insurance, the whole employee experience is impacted by a triad that includes the Insurer, Third Party Administrator, and the Hospital.

Here are the top 5 reasons

why you should buy Employees Group Health Insurance only through an Insurance Broker.


1


The Broker understands the technicalities of a policy and translates them for you in simple English. In 2022, it remains a sad reality that the policy wordings the industry uses are the same antiquated ones that were used a century ago. While the industry has started realizing this fact and is moving toward simplicity, it will still be a while till we get there. Meanwhile the Broker can be the interface who translates this complexity into simplicity.


2


Having worked with Clients across Industries, a Broker is not only aware of the Insurance best practices but also best practices across other Industries. The Broker can therefore help with buying a good Insurance policy and help fine tune any gaps that you may face with its implementation; this short term investment can thus translate into a significant long term gain of time and energy.


3


An Insurance Broker is responsible for balancing TPAs' and Insurers' promises and delivering standardized experiences. The Broker can be your one point of contact. They know who to contact for what, and more importantly when to escalate issues to whom for resolution.


4


Health is undoubtedly one of the most technical verticals amongst all of the Insurance lines of businesses(LoB). The complexity of this LoB can be gauged from the fact that the frequency of circulars and clarifications on IRDAIs website are the most for this vertical. Miss one circular and it might cost your employee a good 30-40 thousand, but it can set ablaze a fire that could burn for an entire year. The Broker ensures this doesn't happen. Insurance Brokers represent their Clients as opposed to an Insurance Agent who is a representative of the Insurer. The Broker bears the legal responsibility of protecting your interests when you buy an Insurance policy. They are bound by the Insurance Regulator to perform as per the terms laid to them.


5


The Insurance Broker adds significant value to the whole experience and administration of group insurance. The Broker doesn't sit on the sidelines watching you go through a horrible claim experience. The industry experience they have gathered over the years translates into actionable items that ensure you have an "aha" experience, every single time


Hence buying Insurance from an Insurance broker is like
"Insuring the risk of insuring the risk".



Checklist for evaluating your Insurance Broker

Consider the following factors when evaluating your Insurance Broker


Your Insurance Broker will ask for this
data to get you the best premiums

  • Claims Dump provided by your current Insurer or TPA. It has data of all the claims made by your employees in the current policy year. It is better to provide 3 years claims data if possible, it really helps to capture the trend and negotiate better with underwriters.
  • Master data of members that are required to be covered under the policy. Many insurance brokers provide software that can be used to capture employee data by opening up an enrollment window for all employees.
  • Copy of your Current Insurance policy and Premium statement.
  • Details of any Employees Wellness program conducted or going to be conducted. Underwriters prefer to offer better premiums to companies that focus on employee wellness and conduct wellness initiatives periodically.
  • Projection of increase in group size or any other insurance policies. When brokers show underwriters the possibility of placing other insurance policies that are more profitable to insurers, they can negotiate better with them.
  • An Email Mandate from your end, authorizing an insurance broker to negotiate the terms on behalf of you.


Below are the best practises to
choose the right Insurance Broker

  • References of those clients who recently left their services.
  • Put the broker service team through a test call by posing as an employee of the existing client and asking for assistance in settling the claim.
  • Ask your broker to sign a Service Level Agreement. You may like to refer to this draft template and modify it further as per your requirement.
  • A client involving more than one broker for negotiating with the insurer creates a negative impact on the negotiations. It implies that the client does not fully trust the insurance broker. Therefore, it is wise to choose only one exclusive Insurance broker for Group Health Insurance.