Page 268 - Ebook health insurance IC27

The Insurance Times

receive inputs from various stakeholders and the market intelligence, and ensure
that the process gaps are integrated and plugged. Internal control functions also
ensure that the processes are adhered and implemented by the respective
stakeholders.
(xii) Controls through Insurance Covers - General Insurance, as such offers various
products like Fidelity Insurance, which many insurance companiesavail to minimize
loss due to employee frauds. Similarly, various specialized tailor made covers are
also available to safeguard the companies themselves.

Q9. What initiative have been taken by the IRDA and the industry for detection
of frauds.

Ans. After banks, it is now the turn of the Insurance Industry to build a customer
information database that will check frauds and enable pricing of products based
on individual profiles. The Insurance Regulatorhas set up apolicyholder information
database - the Insurance Information Bureau. This database can provide output in
the lines of Credit Information Bureau, which caters to the banking industry.

The objective is to maintain a database of all insured vehicles and health insurance
details to facilitate more efficient underwriting. Just as banks determine the credit
worthiness of an individual by quering CIBIL, insurers would be able to get the
worthiness of a policy holder while applying for a new policy.

An online database would enable an Insurance company to verify whether an
insurance has good insurance track record or not. The insurers can then coordinate
amongst themselves to combat fraudulence in the system.

272 Guide for Health Insurance