Annual Household OOP Savings
₹18,450
32.5% reduction in out-of-pocket spend
Estimated Post-Reform Premium
Claim Approval & Speed Index
94%
Avg processing: 12 days
Hospital Billing Breakdown (Pre vs Post Reform)
Loss Ratio & Claim Settlement Leakage (%)
Empirical Impact Matrix & Math Models
| Demographic Profile | Avg Pre-Reform Bill | Post-Reform Bill | Pre Household OOP | Post Household OOP | Net Savings |
|---|
Math.js Policy Calculation Formulae:
• Post-Reform Billing = Base Bill × (1 - (Standardization Rate % × 0.45))
• Household Out-Of-Pocket (OOP) = (Post Bill × Co-Pay Cap %) + Non-covered Overhead (reduced by standardization)
• Insurer Loss Ratio Balance = (Claims Paid + Admin Expense Cap) / Total Gross Premiums Collected
• Post-Reform Billing = Base Bill × (1 - (Standardization Rate % × 0.45))
• Household Out-Of-Pocket (OOP) = (Post Bill × Co-Pay Cap %) + Non-covered Overhead (reduced by standardization)
• Insurer Loss Ratio Balance = (Claims Paid + Admin Expense Cap) / Total Gross Premiums Collected