Page 13 - Insurance Times September 2023

TPA of India, a captive services com- Dr Shetty's Narayana group to enter health insur-
pany, for its inability to meet objectives.
ance biz
Sources said a committee comprising
former Oriental Insurance chairman Cardiac surgeon Dr Devi Shetty's Narayana Health group has sought a li-
Anjan Dey and other PSU officials has cense from IRDAI for a health insurance business.
been set up to submit a road map. The group has set up Narayana One Health, and roped in insurance industry
HITPA was incorporated in 2013 in veteran Ravi Vishwanath to lead it. Vishwanath was earlier in charge of
Delhi with two key objectives to en- health and accident businesses at HDFC Ergo.
hance customer experience and in- Dr Shetty's model aims to offer affordable coverage by reducing the cost of
crease efficiency in the PSUs' health treatment in hospitals through economies of scale, sources said. Dr Shetty
insurance claims processing. A corol- (70), who received the Padma Bhushan in 2012 for his contribution to af-
lary benefit would be to reduce the
fordable healthcare, has advocated for insurance coverage where contribu-
bleeding in the health insurance port- tions of many would cover costs of the few who need treatment.
folio of public sector insurers.
Narayana Health currently offers healthcare plans from a provider's stand-
HITPA is a joint venture of five public point. However, provider-led coverage is restricted to the footprint of the
sector insurance companies - National healthcare provider. Health insurance will enable comprehensive coverage
Insurance, Oriental
without any limitations in terms of provider or geographic area.
Insurance, New India Assurance,
"It would be a boon for the industry if the model of affordable health cover-
United India Insurance, and GIC of In- age through cheaper healthcare takes off," said the CEO of a private health
dia. PSU insurers had put Rs 120 crore
insurer. He added that medical inflation tends to be higher than general
into the TPA, which went into building inflation due to frequent upgrades in medical technology. Additionally, even
up the necessary infrastructure.
as health insurance increases demand for healthcare services, capacity cre-
ation takes time to catch up.
Ayushman health insur-
Dr Shetty, who gained prominence for performing the country's first neona-
ance: Private players out- tal heart surgery and being Mother Teresa's physician, founded Narayana

bid PSU firms to bag 2 Hrudayalaya in Bengaluru in 2001. In 2009, the US media dubbed him the
'Henry Ford' of heart surgery for his approach to achieving economies of
states scale in healthcare to reduce costs.

Amid reports about fake accounts in
Ayushman Bharat Pradhan Mantri Jan However, NIC has managed to retain health insurance scheme, the Comp-
Arogya Yojana (AB-PMJAY), the
Jharkhand on the basis of its efficient troller and Auditor General of India
government's flagship health insurance
management of the scheme during the (CAG) has said that Rs 6.97 crore was
scheme, two private sector general last three years. Competition is likely paid for the treatment of 3,446 pa-
insurers have outbid public sector gen-
to hot up for other states when re- tients who had previously been de-
eral insurers to bag AB-PMJAY ac- newal comes up in the future. clared dead in the database.
counts of Gujarat and Meghalaya for
Reliance General Insurance will be The scheme, launched in 2018, has been
the next three years.
earning a premium of around Rs. 150 rolled out in both rural and urban areas
PM-JAY is fully funded by the govern-
crore that will help the company to with the aim of reducing out-of-pocket
ment and cost of implementation is bridge the gap n the health portfolio expenditure for the poor and vulnerable
shared between the central and state that it has with peers. population seeking healthcare.
governments.
In the performance audit, under the
Bajaj Allianz General Insurance has Under PMJAY, Rs. 6.9 crore head "Treatment of a beneficiary
outbid Oriental Insurance Company paid for treatment of shown as 'died' during earlier claim/
(OIC) to win the mandate for Gujarat treatment", the CAG noted that "pa-
and Reliance General Insurance (RGI) 'dead' patients: CAG tients earlier shown as 'died' in TMS
has pushed out National Insurance Flagging irregularities in the audit of (the Transaction Management System
Company (NIC) for Meghalaya in the the Ayushman Bharat - Pradhan of the scheme) continued to avail
competitive bidding. Mantri Jan Arogya Yojana (PMJAY) treatment under the scheme". T

12 September 2023 The Insurance Times