Insurance
Give better deal to health policyholders, says IRDAI

In a circular to insurers and TPAs on June 23, IRDAI has asked them to pass on the discounts received from hospitals to the policyholders

 

To protect the interests of health insurance policyholders, India's insurance regulator has ordered insurers and claims processing agencies to mandate hospitals to reflect the negotiated discounts on the bills.
 
It was only last week the Insurance Regulatory and Development Authority (IRDAI) had proposed the move as part of its exposure draft on proposed regulations governing the third party administrators (TPA) or the health care claims processing agents.
 
In a circular to insurers and TPAs on June 23, IRDAI has asked them to pass on the discounts received from hospitals to the policyholders.
 
The IRDAI's move will enable health insurance policyholders two ways. One, they may be left with a decent sum insured as balance to take care of any future claims during the policy period and two, their cash payout will be lesser if the hospital bill is higher than the sum insured.
 
With the health insurance portfolio logging good growth, insurers and TPAs negotiate discounted rate with the hospitals for treating their policyholders.
 
However, the policyholders are not aware of the same and they would get a bill for the rack rates charged by the hospitals.
 
As a result, their sum insured would go down by a higher amount or they would have to shell out a higher amount out of their pocket to the hospital.
 
On the other hand, the TPAs/insurers would settle the hospital only on the basis of the negotiated rates.
 
Former IRDA member K.K.Srinivasan recently told IANS that there is a "growing suspicion that behind the back of insurers, TPAs are getting paid directly by hospitals based on the quantum of insurance claim settlements" and the proposed measures will help curb such unethical practices, if prevalent.
 
While the contract of insurance is said to that of "utmost good faith", in actual practice it was not so as insurers and TPAs acted behind the policyholders.
 
It is this practice that IRDAI has decided to curb now with immediate effect.
 
According to IRDAI, every insurer and the TPA shall put in place the following procedures:
 
* The insurers and TPAs shall mandate the hospitals to reflect such agreed discounts in the final hospitalisation bill of each claim, by which the policyholder or the claimant can also be aware of the actual bill raised by the hospital.
 
* Where the admissible claim amount is more than the sum insured, the agreed discount shall be effected on the gross amount raised in the bill, before letting the policyholder or the claimant bear the costs over and above the eligible claim amounts.
 
* Where the underlying health insurance policies have co-payment or the deductible conditions, the insurer or TPAs shall ensure that the said co-payment or deductible is effected only after netting of the discounts offered by the hospital, if any.
 
* The insurers and the TPAs shall ensure that every discount received or agreed to be received from the hospital is passed on to the policyholder or the claimant in respect of the underlying claim only in absolute monetary terms.
 
* Every insurer shall make these procedures as part of the detailed guidelines on claim settlement to be provided to the TPAs.
 
* The above procedures shall be applicable to both cashless services and reimbursements of all the claims of health insurance policies

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8 coal mines to be auctioned after 10 in Round 3: Coal secretary

Swarup said that in view of the need to step up India's coal production to 1.5 billion tonnes by 2020, there is a plan to hire manpower for mining

 

The government will put eight more coal mines up for auction after completing the process for 10 mines in the third phase in mid-August, Coal Secretary Anil Swarup said on Wednesday.
 
"After these 10 mines (in August), eight more mines are in the queue," he told reporters here on the sidelines of a conference on minerals and metals organised by a business chamber.
 
"We have more and more mines coming in so that they would suffice for other sectors also," he said.
 
Swarup also said that in view of the need to step up India's coal production to 1.5 billion tonnes by 2020, there is a plan to hire manpower for mining.
 
"As far as 1.5 billion tonnes of production is concerned we have a full-fledged HR plan of having manpower to mine these mines," he said.
 
The third round of coal mine auctions for 10 blocks will be held from August 11 to 17.
 
Coal and Power Minister Piyush Goyal said last month that the government will open more than 60 coal mines across the country in the coming days.
 
He had said the new mines were part of the overall plan for state miner Coal India to double its current production of 500 million tonnes per annum in five years to reach the country's total production target of 1,500 million tonnes by 2020.
 
Coal India achieved a record 32 million tonnes increase in production in the last year, which led to a 12% increase in power production, the minister said.

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CCEA nod for Artificial Limbs Manufacturing Corp financial restructuring

The government had given interest bearing loans totalling Rs21.82 crore to the company from 1977-78 to 2001-02, for meeting its working capital requirements

 

The Cabinet Committee on Economic Affairs (CCEA) on Wednesday approved conversion of the interest of Rs52.14 crore, including penal interest, on a loan of Rs21.82 crore made earlier to the Artificial Limbs Manufacturing Corporation of India (ALIMCO) into equity.
 
"The increase in capital base support will strengthen the financial position of the corporation to fulfill the objectives for which it was established," a CCEA communique said of ALIMCO, which was set up in 1972 as a non-profit organisation.
 
"It will ensure availability of increased working capital required for enhanced targeted business and also enable the corporation to seek loans from financial institutions/banks on favorable terms," the CCEA said.
 
The government had given interest bearing loans totalling Rs.21.82 crore to the company from 1977-78 to 2001-02, for meeting its working capital requirements.
 
According to the ministry of social justice and empowerment, though ALIMCO has fully repaid the loan amount to the government, interest was not paid and continued to be shown as accrued.
 

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