A common databank is needed to make portability work. We don’t have it
Portability will be a non-starter if the features of a policy are not easily portable—as there would be many impediments from the consumers’ angle. There can be a huge issue among the insurers as well, if they cannot, and do not, easily share your data. There is no centralised insurance databank in India which is an essential step to improve the delivery of health insurance in India. The regulator is working on a system of making medical history data available in electronic format across insurers but it is not clear when the system would be up and running.
According to industry experts, insurers, especially in the public sector, don’t have a core system and there is no sharing of data across even divisions of the same company. So, today, it is not easy to port a policy even within the same insurer across divisions. Authenticity of the medical history data with the insurer, in some cases, may be questionable and would lead to disputes after portability. The new insurer is completely at the mercy of the existing insurer to give accurate data.
In such a situation, insurance companies will have to implement the guideline which specifies that the medical details will be shared with the accepting insurer within seven days. Enormous efficiency will be required to achieve this. It may need major changes in processes and database infrastructure to retrieve information of one customer across several years of renewal.
This calls for an agency like the credit bureau, which will run a centralised databank containing all the medical details of customers (pre-existing diseases, claims history, insurance history, coverage limits and so on). There will be a need for a unique customer identification number. The current reports from Insurance Information Bureau are inadequate to achieve this goal. According to Sudhir Sarnobat, “There is a need for an independent agency similar to CIBIL (Credit Information Bureau (India) Ltd) to create a common insurance database. It need not be from the regulator. CIBIL took 10 years; an insurance database can be developed in five years. Insurers may have to put in capital to build it. It can be used to come up with correct premium pricing. The unique ID of the customer will offer ease of information without going to the branch or division of the insurer.” Dr Amarnath Ananthanarayanan, CEO and MD, Bharti AXA General, also feels that, “The evolution of a common database across insurers will be of tremendous benefit for insurers as it will be a risk assessment tool. It will help to understand and access risk and charge the right premium. If an insurer charges high, then they lose the customer; if low, then they will have losses; if right, then they will get customers. Currently, insurers sometimes play safe in underwriting with exclusions to stay out of risk. With a common database, there will be less exclusions and lower premium for good customers who maintain health.” But a database with different attributes of records would be useless. That leads to the fact that medical data of policyholders need to be standardised. The group insurance policyholders’ medical data is not captured by all insurers. Some data may be available with TPAs but it may be incomplete. The common database may not give complete information if data is missing.
With databases comes the issue of data protection. In the US, the Health Insurance Portability and Accountability Act (HIPAA) strictly regulates the sharing of health information; you have to give your written permission. For example, without your authorisation, your medical service provider cannot give your information to your employer, use or share your information for marketing or advertising purposes, or share private notes about your healthcare.
You will need lots of support
The terms and conditions of an insurance contract are not easy to understand. Buying correct health insurance is not easy; porting of insurance will be as difficult. You have to accept the terms of the new insurer and may lose some of the benefits you already had with the existing insurer. Here are some tips for you.
• Advises Fali Poncha: “Policyholders have to understand the sub-limits, co-pays and other terms of the new policy before porting. It will entail finding a policy with more or less same terms. If you want to increase the sum insured, the differential sum insured will be treated as a new application and rules for the new customer will be applicable for it.”
• Some private insurers have already started plans to poach customers with portability. If you already have a policy with one of the four public-sector insurers with a life-long renewal, why would you port to a private insurer offering maximum renewal age? Look for private insurers with life-long renewals.
• Check if you will need to undergo a medical test.
• Give ample time for the portability process to work. Apply for portability at least 45 days before the expiry of the existing policy. This will give time to the new insurance company to do a medical test, retrieve information from the existing insurance company and then underwrite and accept the risk.
• If you are confused, don’t port. The customer looking to port should preferably employ a broker to get good guidance and advice regarding the insurance company to select. The customer does not pay the broker.
The ED has registered the case under the Prevention of Money Laundering Act (PMLA) against Suresh Kalmadi as he had a role in all financial dealings of the OC, by virtue of being its chairman
New Delhi: The Enforcement Directorate (ED) has registered a money laundering case against sacked Commonwealth Games (CWG) Organising Committee (OC) chairman Suresh Kalmadi in connection with financial dealings during the 2010 Commonwealth Games, reports PTI.
The Directorate, which had earlier charged the Member of Parliament (MP) from Pune for alleged violation of foreign exchange rules, has now moved the court to seek his custody and record his statement.
Mr Kalmadi, arrested by Central Bureau of Investigation (CBI), India’s premier investigating agency, last month on charges of cheating, conspiracy and corruption in the Timing, Scoring Result system (TSR) of the Commonwealth Games, is presently in judicial custody.
Sources said the ED has registered the case under the Prevention of Money Laundering Act (PMLA) against Mr Kalmadi as he had a role in all financial dealings of the OC, by virtue of being its chairman.
The findings of the CBI and the ED in the entire Games probe were also taken into account while pressing the money laundering charges, sources said.
The ED, after obtaining the court’s permission, will also question Mr Kalmadi in connection with the money laundering and foreign exchange cases that it has registered in the overlays and the Queens Baton Relay (QBR) scams.
The agency has also asked Mr Kalmadi to furnish details of his bank accounts, movable and immovable properties, instances of foreign travel before the Commonwealth Games held last year, and transactions of foreign exchange in the last few years.
Sources said Mr Kalmadi has asked for a few weeks’ time to furnish these details to the ED.