Niva Bupa Health Insurance Company Limited ($NIVABUPA)

Earnings Call Transcript · May 8, 2026

NSEI IN Financials Insurance Earnings Calls 53 min

Earnings Call Speaker Segments

Operator

Operator
#1

Ladies and gentlemen, good day, and welcome to Neva Bupa Health Insurance Company Limited Q4 and FY '26 Earnings Conference Call hosted by ICICI Securities. Please note that any statements and comments made in today's call that may look like forward-looking statements are based on the information presently available to the management and do not constitute any indication of any future performance. As future performance involve risks and uncertainties, which could cause results to differ materially from the current view being expressed. [Operator Instructions] Please note that this conference is being recorded. I now hand the conference over to Mr. Rushad Kapadia from ICICI Securities. Thank you, and over to you, sir.

Rushad Kapadia

Analysts
#2

Thank you. Good evening, ladies and gentlemen. It is a privilege to host the management team of Niva Bupa Health Insurance Company Limited for their Q4 FY '26 results conference Call. We have from the management, Mr. Krishnan Ramachandran, MD and CEO; Mr. Vishwanath Mahendra, ED and CFO; Mr. Ankur Kharbanda, ED and Chief Business Officer; Mr. Bhabatosh Mishra, Chief Operating Officer; and Mr. Vikas Jain, Chief Investment Officer. So without further ado, I would now like to hand over the call to Mr. Krishnan Ramachandran. Thank you, and over to you, sir.

Krishnan Ramachandran

Executives
#3

Thank you, and thank you to all of you who have gathered this evening, Friday evening to be with us. much appreciate. I'll divide my update into 2 parts. The first is some perspectives on what's going on in the industry. And the second, of course, is Naupa. As far as the industry is concerned, there are a number of ongoing positive developments. The awareness campaign, Achha Kiya Insurance Liya, in Q4 as well, the industry led by health executed on an awareness campaign, which is now an awarded campaign. And all of the KPIs for the campaign in terms of specifically around reach and awareness are certainly very encouraging. And this is a campaign, as you all know, that we will continue. It's a multiyear campaign. The second update is GST continues to be a positive or a tailwind for the industry. Indeed, now with the benefit of the entire H2 behind us, the retail health growth, if you looked at H2 for the industry was about 30%. And with Niva Bupa, our retail health growth for the same period was in excess of 40%. So continued strong volume and value growth on the back of what has been a transformational policy reform. The industry initiatives around hospitals and collaboration around health care continue a pace. The common empanelment initiative has now reached 2,500 hospitals, where the MOU has either been signed or is ready to be signed. The last time we spoke, I mentioned that standard treatment protocols for 8 infections -- sorry, 7 infections are live. Work is at a very advanced stage in terms of adding guidelines for modern cancer treatments as well as robotic surgeries and going live with the standard treatment workflows, and there's 144 of them. All of these initiatives help bring about higher transparency and standardization of care, of care pathways and claims cost is embedded in these care pathways. So I think these are great initiatives to bring about transparency and improve affordability as far as health insurance is concerned. The other big recent positive development, which happened in Q4 is the notification of the [indiscernible] standard or the IFRS 17 global standard, which is now effective April 2026. At Niva Bupa, we've always been reporting or leading with the IFRS accounts. And this is something that we will be going live with starting this quarter itself. And we do view this as an extremely positive development in terms of bringing about transparency as well as standardization in terms of how accounting is looked at within the insurance industry. Coming on to Niva Bupa. When I look back at the financial year, we closed at a strong 27.4% overall growth rate for a GWP of INR 9,433 crores, and I still continue to talk about these numbers on an end basis. So in a similar vein, retail growth was 35% for the full year. Our profit after tax on an Ind AS basis was INR 366 crores on a full year basis, up from INR 203 crores last -- the prior financial year. And our return on net worth crossed double digit for a 10.7% ROE number. Our market share on retail health closed at 10.1% on a full year basis, up from 9.4%. And in Q4 specifically, we moved our market share to 10.4%, up from 9%. On talent, we continue to -- continue our journey of emphasizing and placing a lot of importance in all of the talent management processes. And once more, we were recertified as a Great Place to Work. We continue to figure in the top 25 in banking and financial services. While we still don't know our rank, but we'll certainly figure in the top 100 of all companies of all sizes in India. On customer, a few KPIs that we monitor specifically NPS across more than 25 pivotal customer-facing touch points. On a weighted average basis, this number moved up to 60, up from 55 the prior year. We continue to hold strong on claims settlement at 94% plus on a full year basis. And our journey on analytics, generative AI and technology across the entire value chain continues, and we have more than 30 pilots or projects underway across the entire value chain using some of these modern technologies. Two other customer-centric as well as health cost management measures. One is our preferred provider network, which is now present in 49 cities, more than 1,000 hospitals and 20% of claims in these cities go through these hospitals. And we continue to be a strong health partner of choice for an increasingly large number of Indians as evidenced by the increased utilization metrics on our customer app, whether it's doctors, health checkups or any of the new services that we have launched in the last financial year. With that, I'm going to hand over to Vishwanath for an update on our financial performance.

Vishwanath Mahendra

Executives
#4

Thank you, sir, and good evening, everyone. So like Mr. Rushad mentioned, our profit for the year grew by 80%. The same number for the quarter 4 is 90%, 90% increase over last year Q4. The combined ratio for FY '26 under IFRS has improved by 160 basis points to 101.4% while there is increase in overall loss ratio by 1.1%, primarily due to mix change, this has been more than offset by reduction in expense ratio by 2.7%, resulting in improvement in combined ratio. The expense of management ratio for FY '26 improved to 33.7% from 39.2% last year. This improvement is primarily driven by operating leverage and economies of scale. The AUM, including addition comes to around 36%. So we have complied with regulatory described. An investment yield for FY '26 is 7.2% with AUM of INR 9,670 crores. Solvency ratio is at healthy level of 2.49 as on 31st March 2026. So these were the financial highlights for FY '26. We are open to questions.

Operator

Operator
#5

[Operator Instructions] First question is from the line of Supratim Datta from Jefferies.

Supratim Datta

Analysts
#6

I have 3 questions. Starting with the growth, this has been a very strong year like you articulated at the start. Now thinking of the next 2 to 3 years, assuming that you grow at somewhere around that 25% level, which you have tried to meet and successfully done over the past few years, assuming that you grow at 25%, you will get to somewhere around INR 15,000 crores, INR 16,000 crores [indiscernible] now that I wanted to understand what would you require to go from current INR 9,000 to that INR 15,000 crores, INR 16,000 crores for GWP, what would be the building blocks here, if you could give some color around that? Secondly, when you reach this scale, what kind of operating expense ratios can you operate at an IFRS level? Because your IFRS loss expense ratio has come down significantly since FY '23. I wanted to understand what would be the steady state ratio here? That's the second. And lastly, there has been a lot of discussion around commission and commission regulations. Obviously, everything is speculation. I wanted to understand if there are caps or an absolute reduction in commission, how would you go about mitigating the impact? Would you pass it on to distributors? Or how would you go about addressing that situation? Those are my 3 questions.

Krishnan Ramachandran

Executives
#7

Thank you, Supratim. In terms of building blocks, look, there is going to be continuity in terms of what's historically been the levers for our growth. One of our sources of strength, we feel as a management team and it's a strategic choice is our multichannel distribution architecture. Last year, as you would have seen, we've considerably increased our distribution spread, net addition of 58,000 agents, addition of 50-plus brokers, I think 23 additional financial institutions that are now part of our distribution strength. So certainly, one part of the growth is going to continue -- or a major part of the growth is going to continue to come from the distribution that we already have, and we will continue to invest and grow that distribution. Now layer on to that, this distribution, we will use to tap newer and newer customer segments. For example, we now have a product portfolio that covers practically every income segment, except poor or near poor people across the country. So using the same distribution to tap into more and more customer segments, is a layer that will add -- that is a building block, if you will, on top of the distribution. So products for segments is definitely a building block that will add on top of the distribution. The third one I would add is our strategy on Bharat through our own virtual agency as well as our bank distribution. We have access to every pin code in the country. And one of the distribution strategies that we have been doubling down on for the last 2 years is our Bharat strategy, which takes us into Tier 3 cities and below. We have doubled down in a couple of geographies last year. That's given us success and the idea this year is to expand to more geographies. So broadly -- and of course, we will continue to experiment with new distribution architect or models. But given what we know, and of course, there is a continued inflection towards digital channels, we are seeing significantly faster rates of growth in our own digital channels, whether it's our own or through third parties. So I think that's where our -- that's been our source of growth. We continue to believe that, that will be the source of growth or the building blocks as you refer to it for us. And of course, we will continue to pilot and experiment on variants of new models within this. Bharat is one example, but there are many other examples across and within channels that we will test, pilot and scale as we see success. So that's the first part of your question in terms of where will the growth come from. On the IFRS part, I'm going to request Vishwanath and then I'll come back along with Ankur on the commission part.

Vishwanath Mahendra

Executives
#8

Yes, in case of our long-term view on these ratios, so what we can share with you is combined operating ratio or in case of IFSISR,el says it should be, let's say, 99% or so in FY '29. Now the breakup of this in loss ratio and expense ratio, it may vary, of course, depending on what is the channel mix, product mix, et cetera. But broadly, to indicate the loss ratio may remain stable or may inch up by 100, 150 basis points. And entirely, the [indiscernible] will come from expense ratio. 99% combined ratio will translate to mid- to high teens ROE, which is close to 11% currently.

Krishnan Ramachandran

Executives
#9

And on commission, Supratim to your point, we await guidance from the authority in terms of how they would like to move forward. But our belief is that the single limit on expense of management has been an important and transformational change in the insurance industry. It's in line with what happened in the asset management industry where they have a total expense ratio and they manage costs, including acquisition costs within that. So our belief and prayers to the authority continues to be around keeping a single limit of expense management and maybe a glide path to lower that. That is our belief. But look, I think what we have seen with the GST experience is that lower price, our affordability does translate into volume and value growth and more robust production for customers. So we are confident that whatever the authority comes up with we will make sure that the distribution is appropriately remunerated for the efforts that we make. And net-net, it will translate into continued strong momentum. If the answer is it makes the product more affordable. We've clearly seen that volume growth more than compensates for other aspects.

Supratim Datta

Analysts
#10

Just one last question. So on the AUM growth, it seems to have slowed down in FY '26 versus the kind of growth that we have seen in the last 2 years. I wanted to understand, is there anything that needs to be taken into consideration when we're looking at AUM growth for the upcoming years?

Vishwanath Mahendra

Executives
#11

Not really. It has to do with the raise of capital. So that's all. Otherwise, in terms of business, if you keep that aside, it is steady growth.

Operator

Operator
#12

Next question is from the line of Prayesh Jain from Motilal Oswal Financial Services.

Prayesh Jain

Analysts
#13

Congrats on great set of numbers. First question is just on the numbers front. There's some reversal of expense. Could you explain that on the shareholders' account.

Vishwanath Mahendra

Executives
#14

Which one you are referring to, Prayesh, you are referring to IFRS...

Prayesh Jain

Analysts
#15

No, GAAP. Indian GAAP.

Vishwanath Mahendra

Executives
#16

SpeaInd GAAP and you're referring to which [indiscernible].

Prayesh Jain

Analysts
#17

Shareholders' account.

Vishwanath Mahendra

Executives
#18

Okay. Understood. So what happened, till 31st December, we were slightly more than allowed [indiscernible] so we transferred some policyholder to shareholder accounts. Now for the whole year, we met that EM limit, so now that was reversed. So now for the full year, there is no movement from policyholder to shareholder. And that's why the December number has been reversed. That's all. But this is optical only, it [indiscernible] so doesn't change anything.

Pranav Gupta

Analysts
#19

Got it. The other question was on the long-term policy, right? What is the contribution of long-term policy to the overall retail premium today? And how do you see that growth going ahead.

Vishwanath Mahendra

Executives
#20

So long term for us has been similar to what it was earlier years. In the last 2, 3 years, we have been steady. Around 20% of our business comes from a long-term policy. And it's steady -- we've not changed our strategy on long-term policies.

Prayesh Jain

Analysts
#21

Got that. And we have seen a phenomenal growth for the industry in the second half of this year in FY '26. On that base, what kind of growth momentum should we see a normalized level growth for the industry, which will stabilize at about 20%. So just thoughts out there once this base comes into picture, how should we think about growth for the industry over the medium term?

Krishnan Ramachandran

Executives
#22

So at least our view on this has not changed, Prayesh, which is that on the retail side, 17% to 19% CAGR if you take a 5-year view. So broadly, that's where we think the industry growth rate will continue to be at.

Prayesh Jain

Analysts
#23

Okay. And the last question is on the channel mix. Banca again has been at the regulators' key focus areas and Banca recently contributes to our premium. Do you see any challenge there in the medium term?

Ankur Kharbanda

Executives
#24

So in fact, what we have today is a very diversified channel mix. In fact, if you would look at the numbers, our overall agency has -- mix has gone up by 1.5% Banca remaining a little lesser than what our overall digital business has gone up in terms of our overall mix. We feel whatever changes -- one of the changes, exposure draft has already been there from RBI is that there are no changes which are happening on the banca side. Commission side, I don't think so much change will happen on the business, so to say, specifically because we have a large amount of retail business coming, which we are sourcing along with the bank, which should not change there. In fact, our growth rate on retail business on bank is around 46% new business. And we have been consistently doing that.

Krishnan Ramachandran

Executives
#25

I mean just to add, Piyesh, to what Ankur said, one is, of course, with banks, our emphasis is on retail to either branch banking or tele. And asset is cross-sell. So the point which Ankur made on RBI guidelines since a lot of what we do on asset is cross-sell, again, to that extent, it is [indiscernible].

Operator

Operator
#26

Next question is from the line of Sanketh Godha from Avendus Spark.

Sanketh Godha

Analysts
#27

So the first question, Vishwanath, if you can quantify your group health loss ratio for the year or the cost would be useful. And second is -- whether in the fourth quarter, whether there is any change in group health mix towards more indemnity, which expedited or corporate health which expedited your compliance related to compared to 9 months? And lastly, from an IFRS point of view, if you can give your outstanding that number in the balance sheet broken down into both retail and group, if possible?

Vishwanath Mahendra

Executives
#28

Sanketh, first group health loss ratio is around 6.5% for the year FY Actually, IFRS accounts along with annexures and schedules will be available on our website most probably next week. So there we'll have all those details which you are mentioning third question. But what was the second question?

Sanketh Godha

Analysts
#29

Second was more on group health composition, whether it has changed in the fourth quarter. Typically, we have 2/3, 1/3, that is 1/3 is corporate health and 2/3 is -- sorry, banca-based health. So whether that number has changed or it is broadly the same?

Ankur Kharbanda

Executives
#30

Similar, no changes as such, similar to what it was in the previous year as well and the earlier quarters.

Sanketh Godha

Analysts
#31

Understood. And lastly, if you can -- just wondering there is a kind of improvement in the retail health loss ratio every quarter. So basically, it is better around 66.8%, and it has been improving every quarter from when you reported 1H it was 68.1%, 66.9% and 66.8%. So anything to read there whether this trend will continue? Is it more to do that you are growing a little more new business and mix changing in the favor of new is driving that number? Or in general, have you seen frequency severities or even your claim management from hospital point of view played a role for this consistent improvement from 1H to FY '26.

Krishnan Ramachandran

Executives
#32

Sanketh, one is -- this is Krishnan, and I'll request Vishnath and D to add. But broadly, there is seasonality to our claims ratio driven by the post-monsoon infections. See, broadly, the way I would characterize our approach to claims ratio in general and specifically retail is we do have a plan that we work off, right? And that plan, as Vishwanath often says, does factor in for basis points worsening, if you will, of retail claim ratio, but more than compensated by operating leverage. So broadly, we are fairly comfortable with the level at which we are operating. And we in terms of target, I don't think we want to target the claims ratio that operates below where we are because you also have to understand that there has to be value to customers. There's a lot of regulatory and policy oversight around making sure that products are affordable, there's value to customer, et cetera, et cetera. So we are quite comfortable with where this is operating. And in terms of the underlying incidence rates, claim sizes, all of those are in line with our assumptions that is what I would [indiscernible],

Sanketh Godha

Analysts
#33

The reason I ask, is that maybe on a year-on-year basis, it deterior80ps. I understand there is seasonality. But given deterioration is not that huge, but the kind of savings you made on cost is meaningfully very high. So I understand the point that on renewal, the costs are meaningfully very low compared to loss. So overall combined might not change. But eventually, you ended up reporting a better combined. So just wanted to understand whether the quality of loss ratio compared to what you wrote last year in general in the product is improving? Or is it [indiscernible] because the new grew very fast and that led to that improvement because OpEx also improved along with it, that is the reason I was asking that question.

Krishnan Ramachandran

Executives
#34

So look, in terms of quality, our approach has been consistently around driving a lifetime value approach to every policy we write. So in terms of quality, nothing significant to indicate. In fact, the quality only continues to get refined and improved over time, Sanketh.

Sanketh Godha

Analysts
#35

Understood. Understood. And lastly, I don't know whether you will be comfortable giving this data point or not. Out of the total INR 6,582 crores from retail health, how much is fresh fresh? And within that fresh, how much is long term?

Krishnan Ramachandran

Executives
#36

So look, in terms of new, let me call it new and renewal that mix is roughly 40-60. And in terms of [indiscernible] that ratio has been stable between 20% and 25%.

Sanketh Godha

Analysts
#37

Understood. And sorry, in the 40% of fresh, how much would be long term? You said for the overall premium it is 20%. So just wanted to on fresh long term.

Krishnan Ramachandran

Executives
#38

Broadly in that ballpark only, Sanketh.

Operator

Operator
#39

[Operator Instructions] Next question is from the line of [indiscernible] from Maximal Capital.

Unknown Analyst

Analysts
#40

So sir, my question is again on the same as for the previous participant. I mean because the growth is also the kind of premiums just wanted to understand how the renewal book is performing in terms of claims ratio and those vintages has been the performance in terms of the claims ratio.

Vishwanath Mahendra

Executives
#41

So overall renewal book, we can share with you and we have shared earlier also that the combined ratio of renewal book is more like 97%, 98% and we are comfortable with that number. And that's been this year, last year. So that's something that we can share

Unknown Analyst

Analysts
#42

So sir, you guided that the claims ratio would be more or less in the similar level going forward. So hence the question I mean because growth is also led by fresh premiums. So can we see that kind of inching forward -- so that's why the question. [indiscernible] Sir, the second question is on the expense ratio. You mentioned the benefit will come from the expense side that would be in the order of 2% to 2.5%. So what are the levers for improvement would be on operating leverage or something else if you want to call.

Vishwanath Mahendra

Executives
#43

Yes. 2-3 levers. One is the business mix change, like you also mentioned new renewal. So the renewal has much lower cost, both cost of acquisition and cost of administering policies, so that's one lever. Second is sheer economies of scale. The overheads, fixed overheads grew by inflation, let's say, 6%, 7% while you have seen we are growing at last year was 27%. So that's second. And third, a lot of investment has been made in technology, analytics, Gen AI. So that's also something which is helping to bend the cost curve. So these are the 3 major levers.

Unknown Analyst

Analysts
#44

Final one is on accounting if you can just explain a bit on the IFRS [indiscernible] like accounting versus the accounting per [indiscernible] so there seems to be like if you can give some qualitative color on how to think about [indiscernible] the service revenue as per IFRS I mean that would be really helpful.

Vishwanath Mahendra

Executives
#45

Sure. I can very broadly cover. So under IFRS, the top line is gross earned premium. So they don't have net and premium. So it is gross and premium and gross incurred claims and cost of acquisition as insurance service expense and the entire cost of reinsurance is given in one line which includes [indiscernible] earning on that it includes the commission we receive again amortized and third, the claims we receive or going to receive on that premium. So this is how it works. So we have insurance service revenue, which is equivalent to gross earned premium. Second is gross insurance service expense, which includes incurred claim and amortized commission of cost of acquisition and third is cost of reinsurance and that leads to insurance service result and then we have overheads and investment results.

Operator

Operator
#46

Next question is from the line of Shobhit Sharma from HDFC Securities Limited.

Shobhit Sharma

Analysts
#47

Sir, I have 3 questions. Firstly, on your average ticket size. So if I look at your average ticket size has grown by 4% at the overall level, which is lower than the overall growth in the agency average ticket size. So just wanted to understand this at the channel level as you've seen -- as you can see the long-term policy have taken on this. So -- and one of your large distribution partner has been focusing more on the [indiscernible] should have been in line with the agency channel growth should have been. So what has led to this [indiscernible] retail growth being lower than the [indiscernible]. Secondly, if I look at your number of lives has grown by 25-odd percentage, so can we split that growth into retail and group business? Just wanted to understand that how much of the retail business growth has been driven by the new lives. And sir, lastly on your IFRS numbers. So when I went to your 9 months view, you had recognized losses from the onerous contracts on the group side. I'm assuming you would have again recognized those losses on the 12 months number when the comes out. So can you help us understand what's our approach or strategy or the need for underwriting these on contracts?

Ankur Kharbanda

Executives
#48

Sure. Let me answer the first 2 questions, and I'll ask to Vish to answer the third one. Let me first attempt to answer the second question first. Overall growth for the organization was 35% and volume growth out of this is 24%, so we have not just grown on value. Volume growth has been very consistently up and it is at 24%. On ticket size, on your question, you are relating it to some other data point, but let me tell you one more data point. Last 6 months versus first 6 months, the ticket size has grown by almost 14%, 14.5%. That's the big ticket size jump, largely contributed by GST, both on fresh business and renewal, which ultimately helps us with a better premium per life and helps us in better overall profitability for us. Has it grown in some channels? In all retail channels, it has grown consistently, not looking at -- I do not have the split of channel wise. But if you just look at the retail channels, all of our channels have grown in the ticket size, both on fresh and renewal business. I'll have Vish to [indiscernible] first point.

Vishwanath Mahendra

Executives
#49

Sure. And again, just to add the average ticket size and GWP per policy sold by agent, the difference is not only other channel, it is also group and retail. So the first line is all put together, which is B2B, B2B2C. So more relevant is the GWP sold by agent, which is primarily -- which is actually retail and Ankur has anyways clarified the growth in ticket size. On 31st December, yes, there was loss component. And around equal amount was there last financial year also. So as such there is no impact of that in last financial year because previous financial year also similar number was there. And there was no loss component in last quarter. In fact, if at all, it was unwound.

Shobhit Sharma

Analysts
#50

So just wanted to understand what's our strategy is requiring us to write these onerous contracts.

Vishwanath Mahendra

Executives
#51

Yes. So actually, the -- if we create a loss component on onerous contract, it is not necessarily that these are unprofitable. So the concept is we need to consider expected loss ratio on expenses and risk adjustment. So assume that you are writing an account at 100% cost and investment income is your profit, let's say, in this example, still you need to create loss component, let's say, if you are taking risk adjustment of 5%. So anything which is, let's say, 95% or above, you need to create loss component on that. So it's not necessarily that this is loss-making. It is just that IFRS says if it is after risk adjustment more than 100%, then you upfront create provision for that. And during the policy cycle, you keep unwinding that.

Operator

Operator
#52

Next question is from the line of Nischint Chawathe from Kotak.

Nischint Chawathe

Analysts
#53

On the incurred claims amount of around INR 5,000-odd crores, can you break this between actual claims and claim management expenses?

Vishwanath Mahendra

Executives
#54

So claims management expenses generally is 3% of [indiscernible] GWP, Nischint.

Nischint Chawathe

Analysts
#55

And the ratio remains similar this year, is it...

Vishwanath Mahendra

Executives
#56

Yes, it's similar. [indiscernible] number...

Nischint Chawathe

Analysts
#57

So if I sort of look at the net claims ratio that kind of moved up from around 59.4% to around 61.3% for the year. So how should we read this ratio? Any specific reason why how would you interpret this ratio and the rise? And how do we see this going forward?

Vishwanath Mahendra

Executives
#58

And you are referring to IFRS numbers or...

Nischint Chawathe

Analysts
#59

IFRS, all IFRS numbers.

Vishwanath Mahendra

Executives
#60

So IFRS results, loss ratio.

Nischint Chawathe

Analysts
#61

Yes, I'm just saying you look at net claims ratio, that is net of claim management expenses. I'm saying that sort of moves on from 59.4% last year to 61.3%.

Krishnan Ramachandran

Executives
#62

I think the better thing is to look at retail because the mix between retail and group can explain other changes. So if you look at retail, that's the better answer explanation for you to give.

Vishwanath Mahendra

Executives
#63

Yes. This is not really increasing that much. It is similar in quarter 4, yes, the increase in reported number may be higher, but you are calculating, that should show a very small increase, Nischint.

Nischint Chawathe

Analysts
#64

Got It. And the entire claims management can be -- I mean, it has to be sort of a equally on a pro rata basis between retail and corporate? Or would you kind of allocate everything to retail?

Vishwanath Mahendra

Executives
#65

No, no. We allocate the proportion of claims...

Operator

Operator
#66

Next question is from the line of Prayesh Jain from Motilal Oswal Financial Services.

Prayesh Jain

Analysts
#67

Just on the hospital that you mentioned that I think some 2,000-plus hospitals are kind of panel on the various measures on protocols and infections, standard procedures for infections that have been taken. Are these large hospitals could you give us some color as to what kind of hospitals have been tied up with any large chain has kind of come on board? Because since the number is still too small, what are the large chains talking about this? And when do you see the benefits of this kind of coming in for the industry and [indiscernible].

Krishnan Ramachandran

Executives
#68

So, as I mentioned, when we first started this initiative, broadly the common empanelment, what we wanted to drive as an industry is a critical mass of hospitals to be signed up. And we consciously chose to leave out the top 20 groups. And maybe we will have a different strategy for the top 20 groups. So the emphasis is on outside of top 20 and 2,500 that I referred to would be outside of the top 20-odd. And the idea is to get to maybe 5,000 in the next 4, 5 months. We have ironed out all of the operational topics around common [indiscernible], We have our tech platform, et cetera, et cetera. In terms of benefits, look, the industry will -- to the extent that we have claims flow to these setups, the industry already is seeing benefits from this initiative and also certainly benefits from the initiatives around standardization because as I mentioned, a good part of the cost when it comes to claims is captured in the care pathway. So the treatment choices that get made fundamentally determine what will be the length of stay and the average claim size. And as we standardize that, that is a significant positive impact to the industry. So I just want to reemphasize how important that is. Dr. Bhabutosh wants to say something.

Bhabatosh Mishra

Executives
#69

Yes. Prayesh, thank you for your question. The first expectation and a big mandate is to enhance access to hospitals for every insured person. And from that point of view, in Phase 1, the midsize and other hospitals have been focused on. So that access goes up because the top 20, as you know, are already a part of almost every insurer's network or TPA network. It's a mid-segment where more focus has been done to enhance access to Cayman's insured population. The protocols that Mr. Krishnan mentioned about and which you asked are applicable to all providers, whether across the length and breadth of segment of providers in the country, which basically in interest of consumers in bringing transparency, in getting right treatment for right conditions at right severity, it will be very beneficial to market in general. And specifically, it would also have a bearing on cost optimization when it comes to clean cost by rationalizing the treatment, optimizing the treatment protocols.

Krishnan Ramachandran

Executives
#70

Doc, maybe you can make that real with robotics as an example, right?

Bhabatosh Mishra

Executives
#71

Yes. In robotics, for example, with the advancement of modern medicine, robotic is available. Although globally, what is followed is very robust, what you call is health technology assessment or health economic evaluation, basis that robotic get incremental health benefits but at appropriate cost. When that protocols are applied globally and now increasingly in India, as we discussed and Mr. Krishnan mentioned earlier, would mean that how much incremental benefit robot usage against conventional laparoscopy usage in a particular surgery is gaining and what is an appropriate cost for that for the gain in many surgeries, you will find, for example, small, small surgeries like fibroid removal, et cetera, robot incrementally does not add much health benefits, but it costs comes at possibly a significant cost, which is not appropriate to the benefit gain. Those are the issues and protocols through HT and HA that are getting addressed gradually.

Prayesh Jain

Analysts
#72

Yes, it does. But just a follow-up on that. Do you think this would lead to kind of more challenges with customers on the kind of treatment that the hospital would suggest and what the customer would want and what the insurance company is going to settle for?

Bhabatosh Mishra

Executives
#73

In fact, Prayesh, I think this is in interest of consumer mostly because then the consumer would be very much aware that what is the appropriate care and treatment for him or her. And transparency in health care practices will set in helping consumers make the right health decisions for self.

Krishnan Ramachandran

Executives
#74

And look, this is something that globally, a journey that many, many mature markets now practice to a very large level of maturity. This is a journey that has begun in India. For example, the initiative on infections, where we standardized admission criteria for 7 infections. It has now been live for 9 months. And I think there's been a net benefit in terms of transparency and see customers understand what customers don't want is surprise. I think this eliminates surprise all sides, right? So in all these initiatives, clearly, there's communication out to hospitals, there's communication out to customers. And when there's a claim, then there's less and less surprise when we take a position on why we -- because everybody has been informed on why we are doing what we are doing. And then, of course, some customers may still choose to pay out of pocket and undergo a certain treatment, but then it's not a surprise.

Bhabatosh Mishra

Executives
#75

These are very evidence based. There is enough and more literature even within the country that is available. And all these are based on very, very scientific evaluations by very appropriate government and nongovernment authorities.

Prayesh Jain

Analysts
#76

Got that. Any development on the national digital health mission that was picking up some momentum until some time back. Now we don't hear anything about it. What's happening on that? And in fact, that was supposed to help the outpatient insurance as well. So where is that? And how is that kind of shaping up for the industry?

Bhabatosh Mishra

Executives
#77

Thank you, Prayesh. In fact, there is renewed focus and energy around some components in a freeze manner on the national digital health mission. I would perhaps give you an example of the National Health Claims Exchange, where both payers, providers have come together to adopt it in a meaningful -- in a very big way. Those works with various industry bodies through the regulator and other agencies, including NHA GIC is on. And there's a lot more work that is being done, which is likely to see very positive results fairly sooner than later.

Prayesh Jain

Analysts
#78

Got that. Last question, if I look at commissions on the Indian GAAP numbers, the commission ratio has come down sequentially in spite of the mix moving towards retail health and fresh business. What explains that?

Ankur Kharbanda

Executives
#79

Largely, this is towards 2 things. One, the senior which we rolled out from 1st of April last year, the reduction in commission on the senior. And second is on the GST impact as well. So both of these are the reasons why this has gone down.

Operator

Operator
#80

Ladies and gentlemen, as there are no further questions from the participants, I now hand the conference over to the management for the closing comments.

Krishnan Ramachandran

Executives
#81

Thank you very much. I appreciate you taking time on a Friday evening and for all your questions. If there's anything further, please do feel free to get in touch with us to Himanshu. Happy to address any further questions any of you may have. But thank you once more, and have a happy weekend.

Rushad Kapadia

Analysts
#82

Thank you, sir. On behalf of ICICI Securities, that concludes this conference. Thank you all for joining us, and you may now disconnect your lines.

For developers and AI pipelines

Programmatic access to Niva Bupa Health Insurance Company Limited earnings transcripts and 32,000+ others is available through the EarningsCalls.dev REST API. Plans from $24.99/month — full transcripts, speaker segments, full-text search, and the recently-added /api/v1/transcripts/recent polling endpoint for ETL pipelines.