Page 7 - Insurance Times November 2019

IRDAI

News

IRDAI says insurers can IRDAI & NHA propose hospital registry, empanelment

change rates by up to 15% process, grading
without its permission IRDAI’s joint working group and the National Health Authority (NHA) has re-
cently made proposal of a unique common
In a recent development, IRDAI has
permitted in- hospital registry, empanelment process,
surance compa- grading of hospitals and package cost
nies more free- harmonisation with an aim of promoting
dom in revising the standardisation and effective utilisation
rates. Insurance of health care infrastructure under the in-
companies can now increase or de- surance programme.
crease premiums by 15% depending Health care schemes and private insurance at present have individual hospital
on their claims experience in a cer- empanelment process, which replicates various activities and contributes to
tain sector. Therefore, if an insurer inefficiency and duplication of processes.
experiences higher claims and
higher loss ratios in health or motor The Report of Network Hospital Management, prepared by the IRDAI-NHA joint
going forward, it will be easier for working group states, “It is recommended to have common empanelment
them to increase premiums without portal which can be utilised by all the schemes/insurance companies with
having to file with the IRDAI. standardised empanelment criteria will be hugely beneficial with special fo-
"If we face a better than expected cus on standard safety and quality parameters.”
experience in a certain category,
then it is possible that we might It has been recommended by the group that a standard grading system for
pass on the benefits of underwriting hospitals, based on the quality parameters should be prepared, and same grad-
profits in the form of lower premi- ing can be used by PMJAY (Pradhan Mantri Jan Arogya Yojana) and the private
ums," said Rashmi Nandargi, head insurance market.
(retail health, PA and travel under- The sub-committee of the group said, “An exercise should be done to agree
writing), Bajaj Allianz General Insur- on these common grading parameters in discussion with National Accredita-
ance. IRDAI also declared other tion Board of Health also.”
measures to bring in more transpar-
ency. Among the changes are allow- “This list will be beneficial as a central health facility repository/registration
ing insurers to alter the mode of number can be used by various schemes and insurance service providers for
premium payment to an instalment identification of the health facilities in geographical areas,” it added.
basis without having to file the
product afresh with IRDAI. IRDAI has asked insurers to ensure that advertisements of insurance products
are clear and do not convey a fabricated sense of security to prospective cus-
Insurers will now also be allowed to tomers.
increase the age band of products
without having to file afresh with The IIRDAI in a circular on 'insurance advertisements' has prescribed dos and
the regulator. don'ts for insurance companies to comply with.
The Insurance Times, November 2019 7