Industry

We’re disrupting traditional health insurance by adding a layer of preventive care: Mayank Kale, Loop Health


Before starting Loop Health, Mayank Kale worked on creating digital health records for patients. During that period, he uncovered a basic misalignment in fee-for-service healthcare systems: physicians are paid to treat patients when they are sick, not to keep them healthy.

Mayank Kale, CEO & founder of Loop Health, says “The healthcare system has financial incentives to overprescribe surgeries, diagnostics, and medications. I witnessed how people suffered due to lack of medical education.” Loop Health, an insurance startup wants to change that by bringing in products where physicians and insurers are involved in users’ long term health and well-being.

Pune based Loop Health, has raised $12 million in a Series A round co-led by Elevation Capital and General Catalyst. This round also saw participation from other investors including Vinod Khosla through Khosla Ventures, YC Continuity Fund and Tribe Capital. In an e-mail interview, Kale discusses the Loop Health model and more. Edited excerpts:

There are so many insurance startups with a focus on healthcare? How different is Loop health? What new products and services do you bring to the market?
Loop Health aspires to create a Health Assurance system in which physicians and insurers are involved in their customers’ long-term health and well-being. We’ve brought together primary care physicians, specialty networks, and health insurers under one roof.

We’re disrupting traditional health insurance by adding a layer of preventive care on top of it, putting the emphasis on health rather than sickness, and reshaping it into a more empathic, accessible, and preventive system.

Is Loop a health services provider or insurance provider? How many doctors are part of your in-house medical team? How does it work?
We are a health insurance broker that also provides primary care to all our customers. We play the role of a family doctor for all our members.

Group health insurance (benefits) is an untapped sector in the country, with the majority of purchases conducted by companies’ human resources departments through traditional offline brokers. Existing brokers generally disregard the mid-market and SME segments, which are frequently served by small brokers or are not served at all, to focus on major enterprise customers. In addition, their services are limited to minimum health insurance coverage. We focus on healthcare assurance through integrated primary care and insurance programmes.

We partner with companies to offer employees health insurance plans. With 12+ doctors on board, employees get access to preventive care, a dedicated medical advisor, and additional health and wellness plans such as yoga & meditation sessions, free mental health consultations, discounts on lab testing and medicines, and tailored care planning.

Many startups which are into connecting doctors and patients are struggling and are now trying to focus on medicine delivery. Platforms connecting patients to doctors don’t seem to work in India. Why?
The lack of a comprehensive and empathetic approach to healthcare concerns is the primary reason why health tech startups focused on tele-consultation may struggle to bring value. Patients want more than just free tele-consultation; they want a medical advisor who can help them understand their symptoms, provide basic care, and refer them to the appropriate specialists and hospitals in the event of an emergency.

What has been the impact of the Covid-19 pandemic on group health insurance?
Following the global COVID-19 pandemic, the group health insurance industry has significantly evolved. Businesses recognised the need for comprehensive health insurance coverage in the case of a medical emergency.

In recent years, investments in the health insurance business have expanded. To meet the growing expectations of clients during the pandemic, insurance companies have implemented a variety of improvements, including the launch of covid-specific health insurance products, the provision of flexible solutions for customers, digitization of the onboarding and claims process, and enhanced claim settlement.

We have more than 150 clients and insure and care for 50,000+ employees at these organisations which include Shaadi.com, Rediff.com, Helpshift, Knorr Bremse, Shoptimize, Weikfield, Moonshine Meadery, to name a few.

In how many hospitals is Loop insurance accepted? Do you also cover procedures like robotic surgery?
We collaborate with almost all of India’s leading group health insurance providers. The insurance is approved in all hospitals with a minimum of 25 beds, which totals nearly 25,000+ in India. Taking into account recent technological breakthroughs and medical experimentation, the insurance regulator IRDA has advised that insurance companies incorporate robotics surgery in health insurance.

Few insurance providers in India provide plans that cover up to 50% of the costs of procedures such as robotic surgery. The proportion of coverage varies by the company since it results in a higher insurance premium.



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