Common claim platform?, Health News, ET HealthWorld

IRDAI panel to look at health insurance servicing via proposed new e-portal: Common claim platform?

New Delhi: The Insurance Regulatory and Development Authority of India (IRDAI) has formed a committee to suggest a universal standard health insurance product and also how health insurance servicing can be done via the proposed e-platform. As per earlier media reports, IRDAI has been working on setting up a common insurance servicing platform which would include settlement of claims. The 15-member health insurance consultative committee will help to achieve the goal of universalisation of health insurance in the country, the regulator said in an order dated October 21, 2022.

The health insurance consultative committee will suggest ways to increase the penetration of health insurance in the country including identifying issues and challenges in the value chain and how to overcome them. They will also identify challenges in carrying out the health insurance business smoothly and make recommendations to facilitate ease of doing business.

IRDAI has asked the committee to make recommendations regarding product designs including a universal standard product that is basic and simple. The committee will also make recommendations regarding standardisation of procedures among providers including for capture, collation, and analysis of data.

“The panel will make recommendations to put in place systems for servicing health insurance that can plug into the e-platform envisaged by IRDAI,” the regulator said.

It will also identify concerns relating to policyholder servicing as well as awareness and make recommendations to address them.

The committee will also recommend any other matter which would help in the growth of insurance penetration and deepen health insurance inclusion, the regulator said.

The committee has been constituted for a period of two years, the regulator mentioned. The committee will be led by Rakesh Joshi, a member of IRDAI. It will also have representatives from the healthcare and insurance industries including third-party administrators (TPA). From the healthcare industry, Devi Prasad Shetty, chairman of Narayana Health; Naresh Trehan, chairman and managing director (MD) of Medanta Heart Institute; Alexander Thomas, national president of Association of Healthcare Providers India; Arati Verma, senior vice president of Max Healthcare, and Ajay Nair will be part of this consultative committee.

From the insurance industry, Neerja Kapur, chairman, and MD of New India Assurance; Bhargav Dasgupta, MD, and CEO of ICICI Lombard General Insurance, Mayank Bathwal, CEO of Aditya Birla Health Insurance, and Vibha Padalkar, MD and CEO of HDFC Life, will be part of the committee. The committee will also have representatives from the third-party administrators (TPA) — Nayan Shah, CEO, of Paramount Health Services & Insurance TPA, and Vikram Chhatwal, CEO, Medi-Assist Insurance as members.

“It is necessary for every family in the country to have a health insurance cover. The various elements in the health insurance value chain are required to be visited periodically in order to provide an enabling environment to achieve the goal of universalisation of health insurance in the country,” the regulator said.

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