VHI programs from insurance companies. Ratings of insurance companies operating in the VHI market The best VHI insurance companies

The VHI policy provides its owner with great opportunities compared to compulsory health insurance. With this document, it becomes possible to visit specialists for free, undergo tests and courses of procedures without having to wait in lines.

The price for such insurance starts from 50,000 rubles and increases depending on age and health status. Given the size of the costs, it is worth considering the choice of a company more carefully. This will allow you to get services corresponding to the price.

There are two ways to take advantage of the DMS. In the first case, the contract is concluded with a specific medical center. Although this option provides access to more services and procedures, it limits the client to a particular facility. And if there are problems with cooperation, you will have to deal with renegotiating the contract with another company, which is associated with considerable trouble.

The second way involves contacting the insurance company. The selection of an acceptable firm is based on several criteria:

First, you should pay attention to the ratings of insurers provided by independent experts. The assessment of the company's activity is within the limits of A++ to E. In the latter case, the level of reliability is considered insufficient, which leads to the revocation of the license or liquidation. Acceptable for circulation are firms whose rating is not lower than B ++.
Then it is important to pay attention to the amounts of money that are sent for reinsurance, the number of reinsurance companies, including those registered outside the Russian Federation. It is worth correlating the frequency of insured events with the number of unreasonable refusals to pay. An important parameter is the ratio of the sum insured and the amount of damage coverage. If the limit is reached, the policy will automatically terminate.
The last criterion is user reviews.

The conclusions drawn may not always be accurate due to the subjective opinions of other people. However, the conducted research will help you choose the most reliable insurance company.

How to avoid scams

The insurance industry is one of the areas where you can encounter dishonest people. Most often, expensive policies are faked, including VHI. There are two ways to verify the honesty of the insurer.

The first is related to checking the reliability of the company itself. In addition to the main criteria, you can check the duration of the company, whether it has a license to provide services, the number of branches in the country.

The second way involves checking the signed document. Firstly, the policy form is printed on special paper with watermarks and other security features. If a representative provides a simple printout from a printer, don't trust it too much.

important integral part document is the seal and signature of the organization. These elements must be presented legibly, without dashed lines, blurring or other signs that they have been copied from the Internet.

Another aspect in drawing up an agreement is the correctness of filling out the documents. Sometimes the agent deliberately enters erroneous information into the policy, and then corrects them on his own. Such things should be treated with caution, as a document with corrections is not considered valid. And don't expect payouts.

Rating of insurance companies VMI TOP 10

According to statistics recent years, more than 90% of VHI collections are accounted for by 30 insurance companies. Moreover, the leading position among them is occupied by:

SOGAZ;
RESO-guarantee;
Alpha insurance;
Ingosstrakh;
Alliance;
Rosgosstrakh;
ZHASO;
Renaissance Insurance
VTB insurance.

All these companies are registered in Moscow or the Moscow Region.

VMI insurance companies in Moscow

According to statistics, most insurers consider VHI to be an unprofitable area. Therefore, few of them provide a pure service, including obtaining a policy as part of elite business packages. Here are a few proposals operating in the capital:

Ingosstrakh provides access to VMI policies of the Basic, Standard, Optimal, Premium, Platinum levels. They differ in the number of free services. The price range within each group is formed based on the age, health status of the client, as well as the desired level of service. The advantages of working with Ingosstrakh are access to free treatment of diabetes, epilepsy, skin and occupational diseases, which are not always covered by insurance from other companies, access to expensive diagnostic methods, and free dental care. The company owns its own network of clinics and cooperates with a pharmacy network.
RESO-guarantee provides only the basic program. It includes a mandatory package of services, including outpatient care, home visits and an ambulance call. As an addition, the client can choose and additionally pay for diagnostic, dental treatment and emergency hospital services. The advantages of cooperation with RESO are the permission to pay the insurance premium in installments, use discount systems, an unlimited number of consultations, as well as the opportunity to receive high-quality medical care in Russia.
Rosgosstrakh has been providing its services since 1921 and has the highest reliability rating. Apart from basic package VHI services offer protection from tick bites, hepatitis, assistance in case of an accident, as well as the Guest and Health programs. Due to the large number of proposals, it is possible to provide an individual approach to each client, choosing for him the package of services that is optimal in terms of content and cost.

When applying for a policy in one of the recommended insurance companies, it is important to provide truthful information, as well as try to get complete information about the document and its capabilities. This will help reduce the chance of your insurance claim being denied.

How to change insurance

Unlike compulsory health insurance, the VMI policy is issued for a period of one year. After this period, a new contract is required. And if the work of the previously selected insurance company caused claims, then the client has the right to apply to another organization without any problems. To conclude a contract, the insured must provide:

Completed application form;
Identification;
Medical card;
When applying for VHI for a minor family member, a passport of the parent or legal guardian is required;
Foreign citizens are required to provide a migration card, a certificate of registration with the FMS.

Early cancellation of a valid policy is possible for a number of quite objective reasons, such as a change of surname, place of residence or other personal data. The reason for stopping cooperation may be an unreasonable refusal of insurance payments. In this case, you should act in accordance with the rules of the company where the contract was concluded.

In some cases, stopping the validity of the VHI policy is an unreasonable measure. If the client is not satisfied with the conditions of service of the clinic to which he was assigned, he has the right to change the medical institution to another in accordance with the list of clinics cooperating with a particular organization.

What to do if the insurance company refuses to issue

It is worth remembering that not everyone is entitled to monetary compensation under voluntary health insurance. The insurance company may refuse to issue a policy, pay for diagnostics or treatment in the following cases:

if the applicant has a terminal illness (AIDS, addiction to alcohol or drugs);
diseases that are treated in a leper colony or require mandatory isolation;
pathologies involving the appointment of a disability group;
the need for treatment has arisen due to the actions of the insured, who is under the influence of alcohol or drugs;
getting injured due to illegal actions;
body plastic surgery, organ transplantation, endoprosthetics, including all preparatory procedures;
therapy of infertility, impotence, sexual disorders;
dental prosthetics and implantation services;
injuries due to radiation, social unrest or military conflicts.

If representatives of the insurance company see inconsistencies between the data of the questionnaire and the medical card, and also see a desire to use the policy for other than its intended purpose, they may refuse to issue or increase the payment rate. If the document applies to examinations and procedures that are not covered, the specialist will offer to pay for his services on his own. In this case, it is worth fulfilling its conditions, after consulting with the insurance agent.

In cases where the refusal of the insurance company seems unreasonable, you should ask for your decision in writing. Then the document is appealed in pre-trial or judicial procedure.

Conclusion

Voluntary health insurance allows you to provide access to quality treatment, eliminating the need to wait in lines. At the same time, the cost of the policy increases along with its capabilities. And in order to avoid unjustified expenses, you should carefully consider the choice of a company. This will avoid losing funds due to fraudulent activities.

In addition, it is important to familiarize yourself with the list of services and restrictions that are specific to the selected package. So it will be possible to fully use the possibilities of the policy without the risk of encountering justified refusals of the insurer in payments.

AT In 2015, the voluntary health insurance market formally grew, but in reality it narrowed. The volume of fees for VHI increased in St. Petersburg by 1.6%. But we must take into account the rise in prices: VMI policies have risen in price by an average of 5-15%, services in city clinics - by 10-12%.

Employers, who form at least 90% of the total voluntary health insurance budget by purchasing VHI policies for their employees, reduced these costs. Many small companies have simply excluded VHI from their social packages, large and medium-sized businesses have optimized VHI programs by reducing choice medical institutions or refusal of insurance of relatives of employees.

How these difficult conditions affected the cooperation of private medical clinics with insurance companies is demonstrated by this rating.

This year, VHI market experts have developed a fundamentally new methodology for compiling the rating, which makes it possible to combine indicators according to several criteria that were previously evaluated only separately.

1) The amount of payments transferred to private clinics this year was taken into account both according to the data of clinics and according to information on payments from insurance companies (according to reports for the Central Bank from the website insur-info.ru, see table No. 1).

3) Availability of call centers (see Table No. 3).

4) The quality of VHI programs (see Table No. 4).

5) The quality of administration of the process of medical and economic expertise - this rating took into account, on the one hand, the quality of expert opinions (see Table No. 5), and on the other hand, the timing of their provision to clinics (See Table No. 6).

6) Trust of clinics (see Table No. 7).

Real players of the VHI market participated in the rating: 36 insurance companies (last year there were 39). From the register of insurers, except for " dead souls» ICs whose license was revoked or suspended in 2015 were excluded. These are Avesta, ASK-med, Gefest, INSOTEK, Oranta, Help, as well as those with whom a significant part of the clinics terminated the contract due to financial problems in the UK.

Payments to private clinics

“Previously, the indicator of payments to private clinics was not taken into account, but its importance was recognized, because. it reflects the experience of the insurer and the size of the client portfolio. The rating of the current year is unique in that for the first time clinics provided information on the volume of payments by insurers for insured events. For this, a special software, which guarantees the confidentiality of data collection and storage and automatically processes the results to the level of a consolidated report,” says Tatyana Romanyuk, Director of the EMC Clinic, Chairman of the Standardization and Informatization Committee of the SRO Association of Private Clinics of St. Petersburg.

Payment discipline

The level of payment discipline of insurance companies reflects the presence of debts to clinics for 2015 as of April 1, 2016 and the accuracy of meeting payment deadlines in accordance with the terms of the contract throughout 2015.

The list of insurers with debts for 2015 to the clinics of the Association as of March 30, 2016 included only 13 insurance companies. Note that this list has been reduced compared to last year, and in general, the financial discipline of reputable insurers has increased. This is a positive dynamic, it speaks of a good financial condition Petersburg insurance market.

It is also important that insurers have debts to no more than 10% of the surveyed clinics.

“In conditions of economic instability, clinics must constantly monitor the situation on the market, assessing financial risks. These risks are always the same: first, the insurer starts to violate the deadlines for paying bills, then the debts accumulate, then the clinics find out that the license has already been revoked from the IC and the chances of the clinic to receive money for debts from such insurers are zero. True, it should be said that, for example, the Pomoshch company, which lost its license in 2015, restored it at the end of the year. Now Pomoshch is making serious efforts to restore its reputation and is paying off debts with clinics,” comments Lev Averbakh, General Director of KORIS Assistance (SPb).

In general, doctors admit that insurers have begun to advance medical services noticeably more. On the one hand, this is required by clinics, trying to reduce financial risks, on the other hand, insurers themselves are ready to advance clinics, provided they are given discounts.

Call center availability

The quality of work of call centers of insurance companies was assessed by their availability for doctors of clinics when it was necessary to coordinate medical services.

Rating of insurance companies operating in the VHI system

The quality of VHI programs

The quality of medical programs was assessed according to such a criterion as the volume of coordination of medical services, which, in fact, reflects the volume of medical care available to patients under VHI or the level of restrictions (exceptions) under insurance programs.

“This indicator also reflects the specifics of the portfolio of insurance companies: companies that are able to attract paying customers usually offer more comprehensive programs. The presence of reduced programs in many ICs indicates a certain market trend in an unstable economy and reduced solvency,” emphasizes Aleksey Vlasov, Commercial Director of AVA-PETER LLC (AVA-PETER and Scandinavia clinics).

Since clinics are interested in programs that do not limit the quality of treatment, companies that have full programs prevailed ranked higher in the ranking.

Rating of insurance companies operating in the VHI system

“In 2015, a trend that appeared two years ago was clearly visible: a decrease in the level of control from the call centers of insurers. Insurers want to spend less on call center maintenance and give doctors more power to make their own decisions about insurance events. In general, this trend cannot but rejoice, as it is aimed at increasing the satisfaction of the insured patient, increasing efficiency and reducing costs for both parties, teaching doctors to better understand the principles of insurance and the rules for working with VHI programs,” explained the General Director of the Association of Private Clinics of St. Petersburg Alexander Solonin.

Quality of administration of the process of medical and economic expertise

This rating was calculated using two parameters. The first is the quality of expert opinions. The clinics assessed whether there were valid reasons for refusing to pay and how persuasive they were for the doctor (see Table 5). “Often, the acts simply lack reasonable arguments for the reasons for refusing to pay. Such negligence in the work of experts and the lack of dialogue between experts and doctors is a significant drawback, this forms a negative attitude towards the insurance company in the doctor and leads to conflicts that are undesirable for us, ”comments Konstantin Sharko, Operations Director of the SMT holding.

The second criterion is the timing of execution and transfer of expert opinions to clinics (see Table No. 6). "AT recent times some Insurance companies allow themselves to send examination reports after six months or more, without thinking about the fact that, based on the results of examinations, clinics conduct financial and accounting records, as well as explanatory work with doctors, and that this work clinics should be carried out in a timely manner,” said Lev Averbakh, General Director of KORIS Assistance (St. Petersburg).

Rating of insurance companies operating in the VHI system

“We have certain difficulties in cooperation with some insurance companies in this matter. Medico-economic expertise is a process in which there are a lot of white spots, pitfalls and contradictions that tempt the parties to move away from the main goal of the expertise, Oksana Adamenko, Deputy Director of the 21st Century Clinics Network, comments. - Nevertheless, our main task is to provide quality medical care to the insured. And in this our interests fully coincide with the interests of insurance companies. And both sides have difficulties with the availability of call centers. We solve them, integrate processes for faster communication.”

Rating of insurance companies operating in the VHI system

The sympathies of the clinics remained on the side of IC RESO-Garantia. It should be noted that Renaissance Insurance and VTB Insurance, which last year occupied positions 5 and 6 respectively in the trust rating, were also among the top three in this indicator. They managed to move such large insurers as Alliance, Capital-Policy and Rosgosstrakh. However, taking into account all other evaluation criteria, the final rating of insurance companies looks different.

In the final table, the places are distributed on the basis of a multiplicative indicator of business reputation according to the 6 criteria listed above. Thus, according to the results of 2015, IC RESO-Garantiya moved from the first place to the third one, SOGAZ remained on the second one, and Alliance became the leader of the rating.

For more details on the methodology of questioning experts and the results of the rating, please visit the website of the SRO "Association of Private Clinics of St. Petersburg" www.acspb.ru.

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The Association of Private Clinics of St. Petersburg for the third time compiled a rating of insurance companies selling VHI policies to St. Petersburg residents.

In 2015, the voluntary health insurance market formally grew, but in reality it narrowed. The volume of fees for VHI increased in St. Petersburg by 1.6%. But we must take into account the rise in prices: VMI policies have risen in price by an average of 5-15%, services in city clinics - by 10-12%.

Employers, who form at least 90% of the total voluntary health insurance budget by purchasing VHI policies for their employees, reduced these costs. Many small companies have simply excluded VHI from their social packages, large and medium-sized businesses have optimized VHI programs by reducing the choice of medical institutions or refusing to insure employees' relatives.

How these difficult conditions affected the cooperation of private medical clinics with insurance companies is demonstrated by this rating.

Payments to private clinics

The table below shows the total rating in terms of the volume of payments according to a survey of clinics and the site site.

1. RESO-Guarantee
2. Alliance
3. SOGAZ
4. Rosgosstrakh
5. VTB Insurance
6. AlphaInsurance
7. Renaissance Insurance
8. Consent
9. Ingosstrakh
10. Capital-Policy
11. Medexpress
12. MetLife
13. Hyde
14. Liberty Insurance
15. UralSib
16. VSK
17. British Insurance House
18. Energogarant, North European Branch
19. KRK Insurance
20. GSMK City medical insurance company
21. ZHASO
22. MAX
23. Energogarant, North-Western regional branch
24. Transneft
25. CapitalInsurance
26. Absolut insurance (former ISK Euro-Policy)
27. Surgutneftegaz
28. ANCHOR
29. Swiss Garant
30. Investments and Finance
31. Advanced insurance
32. Regionguarantor
33. Insurance business group
34. Support (ex. Opening Insurance)
35. HELIOS
36. Spassky Gate

Payment discipline

The level of payment discipline of insurance companies reflects the presence of debts to clinics for 2015 as of April 1, 2016 and the accuracy of meeting payment deadlines in accordance with the terms of the contract throughout 2015.

1. Investment and Finance, HELIOS
2. Insurance business group
3. MetLife
4. Swiss-Garant
5. British Insurance House
6. Alliance
7. Absolut insurance (former ISK Euro-Policy), Surgutneftegaz, VSK, SOGAZ, Rosgosstrakh, Renaissance Insurance
8. RESO-Guarantee
9. Energogarant North European Branch, Medexpress
10. ANCHOR
11. ZHASO, Capital Insurance
12. AlfaStrakhovanie, Liberty Insurance
13. KRK Insurance, Transneft, Regiongarant, Energogarant North-West Regional Branch
14. Advanced insurance
15. Capital-Policy
16. Ural Sib
16. Spassky Gate
17. Support (ex. Opening Insurance)
18. Ingosstrakh, GSMK (City medical insurance company)
19. Hyde
20. Consent
21. MAX
22. VTB Insurance

The list of insurers with debts for 2015 to the clinics of the Association of Private Clinics as of March 30, 2016 included only 13 insurance companies. Note that this list has been reduced compared to last year, and in general, the financial discipline of reputable insurers has increased. This is a positive trend, it speaks of the good financial condition of the St. Petersburg insurance market.

It is also important that insurers have debts to no more than 10% of the surveyed clinics.

Availability of call centers

The quality of work of call-centers of insurance companies was assessed by their availability for doctors of clinics when it is necessary to coordinate medical services.

1. Support (ex. Opening Insurance)
2. ANCHOR
3. Regionguarantor
4. Energogarant, North European Branch
5. Energogarant, North-Western regional branch
6. KRK Insurance
7. Swiss-Garant, Capital-Policy
8. Insurance business group, VSK, Capital Insurance
9. ZHASO, Transneft
10. British Insurance House
11. Surgutneftegaz
12. Ural Sib, Gaide
13. MetLife
14. Advant insurance, Spassky gates
15. Alliance
16. GSMK City medical insurance company
17. Liberty Insurance
18. Absolut insurance (former ISK Euro-Policy)
19. Renaissance Insurance
20. Investments and Finance
21. SOGAZ
22. MAX
23. Consent
24. VTB Insurance
25. AlphaInsurance
26. Medexpress
27. HELIOS
28. Rosgosstrakh
29. RESO-Garantia
30. Ingosstrakh

The quality of VHI programs

The quality of medical programs was assessed according to such a criterion as the volume of coordination of medical services, which, in fact, reflects the volume of medical care available to patients under VHI or the level of restrictions (exceptions) under insurance programs.

Since clinics are interested in programs that do not limit the quality of treatment, companies that have full programs prevailed ranked higher in the ranking.

1. MetLife
2. AlphaInsurance
3.Capital Insurance
4. VTB Insurance
5. Alliance
6. Capital-Policy, VSK, British Insurance House, Rosgosstrakh
7. SOGAZ
8. Absolut insurance (former ISK Euro-Policy)
9. Liberty Insurance
10. Transneft
11. Medexpress
12. Renaissance Insurance
13. Consent
14. Hyde
15. GSMK City medical insurance company
16. Ural Sib
17. MAX
18. RESO-Guarantee
19. Insurance business group
20. Spassky Gate
21. Surgutneftegaz
22. Support (ex. Opening insurance)
23. Energogarant North European Branch, Swiss-Garant, Ingosstrakh
24. Advanced insurance
25. JASO
26. Regionguarantor
27. Energogarant North-West Regional Branch
28. KRK Insurance
29. Investments and Finance
30. ANCHOR
31. HELIOS

Quality of administration of the process of medical and economic expertise

This rating was calculated according to two parameters. The first is the quality of expert opinions. The clinics assessed whether there were valid reasons for refusing to pay and how persuasive they were for the doctor (see Table 5).

The second criterion is the timing of execution and transfer of expert opinions to clinics (see Table No. 6).

1. MetLife, AlfaStrakhovanie, Capital Insurance, Capital-Policy, Transneft, Insurance Business Group, Spassky Gates, Surgutneftegaz, Opora (former Otkritie Insurance), KRK Insurance, Regiongarant, Investments and Finances, YAKOR, HELIOS, ZHASO
2. Renaissance Insurance
3. Alliance
4. Ural Sib, British Insurance House
5. Medexpress
6. SOGAZ
7. MAX
8. Liberty Insurance, Advant Insurance, Energogarant North-West Regional Branch, VTB Insurance, VSK,
9. Hyde
10. Swiss-Garant
11. GSMK City medical insurance company
12. Rosgosstrakh, Absolut Insurance (former ISK Euro-Policy), Energogarant, North European Branch
13. Consent
14. RESO-Guarantee
15. Ingosstrakh

1. MetLife, AlfaStrakhovanie, Capital Insurance, Capital-Policy, Transneft, Insurance Business Group, Spassky Gates, Surgutneftegaz, Opora (formerly Otkritie insurance), Regiongarant, KRK Insurance, Investments and Finance, ANCHOR, HELIOS, Renaissance Insurance, Alliance, Ural Sib, MAKS, Liberty Insurance, Advant insurance, Energogarant North-West, Gaide regional branch, Swiss-Garant, Rosgosstrakh
2. British Insurance House, Medexpress, VTB Insurance, VSK, GSMK City Medical Insurance Company, Absolut Insurance (former ISK Euro-Policy), Energogarant North European Branch, RESO-Garantia
3. ZHASO
4. SOGAZ, Consent
5. Ingosstrakh

1. RESO-Garantia, SOGAZ
2. Renaissance Insurance
3. VTB Insurance
4. Alliance, Capital-Polis
5. Alpha Insurance, Liberty Insurance, British Insurance House
6. Medexpress, MetLife, Ingosstrakh, Rosgosstrakh
7. Absolut insurance, VSK, Gaide, Transneft, Energogarant (North-Western branch)

1. Alliance
2. SOGAZ
3. RESO-Guarantee
4. Renaissance Insurance
5. AlphaInsurance
6. Capital-Policy
7. Rosgosstrakh
8. VTB Insurance
9. MetLife
10. Medexpress
11. Liberty Insurance
12. British Insurance House
13. Consent
14. VSK
15. Hyde
16. UralSib
17. Ingosstrakh
18. CapitalInsurance
19. Energogarant, North European Branch
20. Transneft
21. ZHASO
22. KRK Insurance
23. GSMK City medical insurance company
24. Absolut insurance (former ISK Euro-Policy)
25. Surgutneftegaz
26. MAX
27. Energogarant, North-Western regional branch
28. ANCHOR
29. Insurance business group
30. Swiss Garant
31. Investments and Finance
32. Regionguarantor
33. Support (ex. Opening Insurance)
34. Advanced insurance
35. Spassky Gate
36. HELIOS

This time, in addition to private clinics that are members of the SRO "Association of Private Clinics of St. Petersburg", 11 other large medical organizations actively working on the St. Petersburg VHI market were involved in the survey. As a result, the total number of respondents was 49 medical companies, which together manage more than 150 private clinics in our city. The questionnaires were filled out by heads of clinics, medical experts, heads of departments and employees of financial services.
This year, VHI market experts have developed a fundamentally new methodology for compiling the rating, which makes it possible to combine indicators according to several criteria that were previously evaluated only separately.
1) The volume of payments transferred to private clinics this year was taken into account both according to the data of clinics and according to information on payments from insurance companies (according to reports for the Central Bank from the website, see table No. 1).
2) The level of payment discipline - in the rating of 2016, two indicators were taken into account: the timeliness of payment of invoices in accordance with the contract and the absence of debt for 2015 (see Table No. 2).
3) Availability of call centers (see Table No. 3).
4) The quality of VHI programs (see Table No. 4).
5) The quality of administration of the process of medical and economic expertise - this rating took into account, on the one hand, the quality of expert opinions (see Table No. 5), and on the other hand, the timing of their provision to clinics (See Table No. 6).
6) Trust of clinics (see Table No. 7).

For each of the criteria, a rating was compiled. These ratings were subsequently combined into the final one, taking into account weight coefficients, the value of which varied from 3 to 30% (see Table No. 8). The largest weight - 30% - belongs to the indicator "volume of payments to private clinics", the lowest weight - 3% - to the indicator "compliance with the deadlines for issuing expert opinions". The availability of the call center was assessed with a coefficient of 5%. Obviously, for private clinics, cash flow is much more important than the availability of a call center.
Real players of the VHI market participated in the rating: 36 insurance companies (last year there were 39). In addition to “dead souls”, insurance companies were excluded from the register of insurers, whose license was revoked or suspended in 2015. These are Avesta, ASK-med, Gefest, INSOTEK, Oranta, Help, as well as those with whom a significant part of the clinics terminated the contract due to financial problems in the UK.

Alexey KRYLOV, "City 812"

How the article will help: You will learn 9 nuances that will make it easier to choose an insurance company.

The VHI program attracts highly qualified personnel to the company, motivates employees without increasing wages, and reduces the frequency and duration of sick leave. Professionals in demand in the market will not even meet with a potential employer if he does not offer health insurance. By purchasing voluntary medical insurance for employees, you will reduce tax payments. However, all the benefits can be obtained only by carefully choosing an insurance company. What parameters should be paid attention first of all?

Insurance company rating.
The status of insurance companies is assigned by independent rating agencies. For example, "Expert RA" (RAEX) - Russian and international rating agency, accredited by the Central Bank and the Ministry of Finance of Russia. The status is assigned based on financial indicators insurers: from the best A++ (maximum level of creditworthiness/financial strength/financial stability) to the worst D - (the object is in default). Choose insurance companies with a rating of at least B++ (Moderate creditworthiness/financial soundness/financial soundness). This rating gives hope that financial stability the company will allow it to fulfill its obligations and involve highly qualified specialists in the execution of contracts.

DMS license.
The Central Bank acts as a regulator in the field of insurance. Data on valid, suspended and revoked licenses can be clarified on the bank's website. If an insurance company's license is revoked or suspended, it does not have the right to conclude new and renew existing contracts. If the restrictions of the license came into force at the time of the validity of the insurance contract, then in accordance with paragraph 4.1 of Article 32.8 of the Law of the Russian Federation of November 27, 1992 No. 4015-1 “On the organization of insurance business in Russian Federation» in connection with the revocation of a license, insurance contracts and reinsurance contracts are terminated after 45 calendar days from the date of entry into force of the decision of the insurance supervisory authority to revoke the license. By terminating the contract for this reason, you will return part of the funds - the difference between the payment for the period for which the insurance contract was concluded and the payment for the period during which it was valid.

The amount of fees.
Fees for medical types of insurance can be viewed on websites dedicated to insurance (for example, "Insurance today", "711.ru"), on the Central Bank website in the section "Publication of reports of subjects of the insurance business" and on the websites of insurers in sections related to the disclosure of financial information. This information is presented in the form of a rating, where the leaders are the companies with the highest fees. The volume of fees shows how actively the insurance company works in this direction: the higher the fees, the more interactions with other market participants - medical institutions, brokers, partners not related to insurance, but ready to provide discounts on services to clients of insurance companies. This allows the insurer to receive the most favorable rates and conditions for customers. Wholesale prices are always cheaper than retail prices, rates for insurance companies and individuals may vary within 30-70%.

Affiliate network.
The more medical institutions the insurer cooperates with, the more clinics in the program it will be able to offer your company in any price segment, from economy to premium. The number of clinics and hospitals in the network, as a general practice, does not affect the price of the company's employee insurance program. But the wider the proposed network, the more convenient it is to use insurance: each employee will be able to choose a clinic near their home or office. And the more geographical coverage an insurance company can provide, the more likely it is to provide all employees with quality medical care. The price does not depend on the region. The cost of services is affected only by the included risks and the set of medical institutions. The rule works both for Moscow and for the regions.

Sums insured.
Sum insured - the limit of payments for risks for each insured person for the entire period of insurance, or the amount within which the insurance company pays the costs of the policyholder for medical services. Now the main insurers in the VHI market set such sums insured, which are almost impossible to exhaust.

Reviews about the company.
Collect and analyze reviews of a prospective insurance company on insurance websites:
Banki.ru, Sravni.ru, ASN. Ask colleagues and partners. Get acquainted with insurance companies on specialized portals, interview employees. Of course, reviews are often subjective, but with a sufficient number of them (at least 10-15), it is possible to identify positive and negative trends, for example: the quality of the dispatcher console, the speed of solving emerging issues. Pay attention to whether there were appeals to the insurer in case of negative reviews and what were the responses. Work with complaints and claims is an indicator of a professional and reliable market participant who cares about his customers and reputation.

Contract price.
When evaluating the offers of different insurance companies, make sure that you compare the price of identical options. It is worth comparing: the list of risks, the set of medical institutions for each risk, the scope of services and exceptions. The cost of a voluntary medical insurance contract varies from ten thousand rubles for budget-level clinics to several hundred thousand rubles for international treatment centers.

Services for a fee.
Find out what your employees will have to pay separately for. Preventive measures, cosmetic services, family planning services and others are usually not included in VHI programs. Also, not all insurers include outpatient treatment of oncological and occupational diseases in their programs, impose restrictions on tests, immunological, allergological studies.

Service.
Find out what services the company is ready to provide you. For example:
personal curators who answer all emerging questions and quickly solve problems;
Personal Area where you can get all the information on the policy without contacting the insurer, make an appointment online;
additional discounts on other products of the company (OSAGO, comprehensive insurance, property insurance);
Additional services and bonuses (policies for those traveling abroad, discounts from partner companies, expansion of the insurance program).

To whom to entrust the analysis of the insurance market.
Usually in large and medium-sized companies, this task is performed by employees of the HR service or the procurement service. But it is more effective if both departments interact when choosing an insurer.

If the thought of a public clinic already makes you feel bad, then you can buy health insurance and be treated comfortably. We tell you how much it costs and what to check before buying a policy so as not to waste your money.

What does the price depend on

Tariffs in the insurance business are quite complicated. The cost of a voluntary medical insurance policy (VHI) can be influenced by several factors:

the level of the selected clinic;

additional options (dentistry, doctor's house calls, the possibility of emergency hospitalization, etc.);

the state of your health;

Your age.

Depending on all these circumstances, the prices for annual care in polyclinics vary from several thousand to several hundred thousand rubles.

Clinic status

Everything is simple here - the more prestigious the clinic, the more expensive it is to be serviced. So, in the insurance company Alliance Life, a policy can be purchased from 13.3 thousand rubles (service at the Oris clinic) to 165 thousand rubles (Medsi clinic in Grokholsky Lane), says Innokenty Maskileison, head of the company's individual insurance department. In the Rosgosstrakh Group of Companies, the price range is even wider: in the insurer's department, a correspondent of Sravni.ru was told that the prices for policies start from 17,000 in inexpensive clinics to 300,000 in status institutions.

Dentistry

Dental care increases the cost of the policy by an average of 10-30%. Thus, in the RESO-Garantia company, an additional option for dental care will cost from 5.2 to 11.2 thousand rubles. And in the insurance company VSK, adding dental services will cost 2-15 thousand rubles.

Hospitalization

The “stuffing” of the policy can also include the possibility of emergency hospitalization - as a rule, this is a few thousand rubles more to the cost of insurance. For example, at IC "Consent" the possibility of providing emergency assistance within the Moscow Ring Road will cost an additional 3,420 rubles.

Individual parameters

To determine the exact cost of VHI for a particular person, the insurer will most likely offer to fill out a medical questionnaire. It spans several pages and contains questions about health. For example, you may have to answer whether and how often you have a headache, whether you regularly take any medications, what diseases you have visited doctors for before, etc. The older the person, the more likely it is that such a survey will be mandatory.

Most insurers do not take into account the gender of the client. But there are exceptions. For example, in the Ingosstrakh company, a policy for women is more expensive than for men.

“Based on statistics (not only of our company, but also of other insurers), women seek medical help more often. This is due to the fact that they tend to take more care of their health. This is primarily expressed in "precautionary" trips to the clinic with minor health complaints. Men, on the other hand, have a certain psychological barrier in front of doctors. They seek help much less often, but in more complex cases, which affects the severity of the disease,” explains Nikolai Sova, Deputy Director of the Ingosstrakh Medical Insurance Department.

How much does a policy cost

To understand how much an average policy costs for people different ages, we interviewed call centers and press services of the 10 largest insurance companies. Details of this process can be found at the end of the text. We found out the prices for insurance, which included dentistry, a doctor's call to the house and, if necessary, the possibility of emergency hospitalization within the Moscow Ring Road. And that's what happened.

Average cost of a VHI policy in Moscow, rub.

It turned out that for people aged between 20 and 50 years within the same company, the cost of the policy changes slightly. But the difference in price between different companies can be significant. For example, the cost of the most inexpensive policy in the category of citizens under 50 is 29,470 rubles, the most expensive in the same category is 99,600 rubles.

The cost of a VHI policy for the elderly is seriously increasing. Starting from the age of 55-60, companies begin to use special coefficients that increase the price of insurance. For example, in RESO-Garantia, for citizens over 60 years old, there is a coefficient that increases the cost of the policy by 1.6 times, and for those over 70 years old - by 2 times.

“For those over 60, the tariffs will be individual in any case and on average 2-3 times higher than the standard ones,” says Innokenty Maskileison from the Alliance Life company.

There are situations in which the insurer may refuse to sell the VHI policy at all. He has the right not to accept for insurance persons who are registered in narcological, neuropsychiatric, anti-tuberculosis, dermatovenerological, oncological and other dispensaries, as well as in centers for the prevention and control of AIDS, or who have a disability of I-II groups. “If we are talking about chronic diseases that lead to death, for example, diabetes of a certain group, then we have the right not to sell insurance,” says Yegor Safrygin, director of the marketing department of the Medicine block of AlfaStrakhovanie SG.

What to check before buying

1. What is included in the policy

Each company has its own policy content. For example, scheduled examinations (medical examination, check up) in the classical VHI are not an insured event.

“This is a separate program developed for individual requests,” says Natalia Kharina, Managing Director for Voluntary Health Insurance of the Renaissance Insurance Group. Therefore, before buying, be sure to study what is included in your policy, what is considered an insured event, etc. It may take time, but then you will not encounter unpleasant surprises.

2. Which polyclinics and hospitals can be contacted

Look at the list of medical institutions that are included in the program. “Make a choice in favor of network clinics that have a team that has been established for years, as well as the opportunity to visit not one, but several clinics of the network at once. It is better to choose those that are geographically closer, ”advises Yegor Safrygin, director of the marketing department of the Medicine block of the AlfaStrakhovanie SG.

3. How can I make an appointment with doctors

It is important that you have the opportunity to quickly make an appointment with doctors. The fact is that many VHI policies are built in such a way that you first need to call the insurance company, it can coordinate something for a long time and only then gives a referral. “The client should be able to directly call the clinic he has chosen and quickly make an appointment with a doctor,” says Yegor Safrygin.

4. What are the exceptions

Each company has its own exceptions to the programs. And sometimes they may seem completely illogical to the average user. Usually, exceptions are written at the end of the contract with the insurance company. Take the time and read them.

Don't forget the tax deduction!

If you bought a VHI policy for yourself or your immediate family (spouse, parents, children under 18), you can apply for a tax deduction and return 13% of its cost. However, you can return no more than 15,600 rubles.

You can apply for a tax deduction at the department of the Federal Tax Service, by mail, through the personal account of the taxpayer.

A set of required documents:

declaration (available on the website of the Federal Tax Service);
copy of the passport;
certificate 2-personal income tax from work;
tax refund application
policy, license of the insurer, payments.

How we thought

We have selected 10 insurance companies that, according to the results of the first half of 2016, in terms of premiums in the VMI segment. This rating includes insurance companies