Page 188 - Ebook health insurance IC27

The Insurance Times

Q4. Write a note on collection and collation of data.
Ans. Data compilation, storage, and analysis in the Indian Health Insurance sector got a

major boost with the inception of TPAs. The TPAs have emerged as the custodian
of enrollment and claims data for their clients. They manage the policy holder
details through the readily available tailor-made software for such purposes.
However, the data stored by different TPAs may have significant variation in terms
of quality and consistency.

Before the Insurance Information Bureau was formed by IRDA in 2009,health
insurance industry used to send the data to TAC since 2004. Section 64 UE of
the Insurance Act, 1938 inter alia authorized TAC to require and collect data,
information etc. To standardize data collection, TAC also published a Health
Insurance Data Reporting Manual which contained detailed instructions on
acceptable data structures.

Data table formats and manual developed by TAC were revised in 2008 and is
now adopted by IRDA. IRDA has authorized IIB as the nodal unit to perform the
function of collecting, collating and disseminating data. By virtue of powers vested
with the IRDA to seek information and returns, under section 14 (2)(h) of the
IRDA Act and under sections 14,21 and 110c of the Insurance Act, all insurers
have been directed to submit information to the Bureau in the data formats specified
by IRDA within specified time limits.

IIB has created a data warehouse which will enable insurers, other stake holders
and researchers to have easy access to validated data from one source. IIB collects
data from all insurers, integrates the data into logical subject areas, stores data in
an accessible and understandable manner, and delivers data/information through
reports and query tools. IRDA is the sole and exclusive owner of all the data

192 Guide for Health Insurance