Insurance
United India defies CIC order; hiding inefficiencies leading to denial of cashless

United India Insurance was told by a CIC order to put data on policy issue date and transfer date to TPAs on its website. It has not done this for over two months. Does it need high-tech to give such basic information or was it is busy developing M-Power, the app which helps its get premium through mobile phones?

United India Insurance Company (UIIC) has not complied with the Central Information Commission (CIC) June 2012 order to start putting information on policy issue date and transfer date to TPAs (third party administrators) from 16 August 2012. As this order is not for retroactive data, there should not be any difficulty to conform. Yet, UIIC has scuttled the issue by saying that the information will be available only when they have implemented Comprehensive Online Real-Time Environment (CORE) software. Is UIIC deliberately not putting the obligated data as it will point to the ongoing bungling of the UIIC promised cashless feature?

 

As per the Right to Information (RTI) reply to Dr Anshu Agrawal, there can be a one-two month delay in giving policy renewal information by the branch office to the TPA. It means that the cashless feature is denied to customer during this period even after policy is renewed. When a customer pays premium for mediclaim policy, there is very less chance of a cheque bouncing. Why is customer penalised for inexplicable inefficiencies of UIIC? While UIIC has developed M-Power, a mobile application for ease in premium payment, why has it not taken any steps for really helping the customers?
 

Read – United India Insurance uses mobile tech for collecting premiums but in other ways it is in a pre-computer era! 
 

At the 28 August 2012 CIC hearing, UIIC Chief Public Information Officer (CPIO) told Information Commissioner following important points:

 

  1. It is the practise that the representative of the TPA visits the branch office on a weekly basis to obtain the information of the mediclaim policies (new and renewed) which are in-force.
     
  2. During the past one year, the company is in the process of putting in place CORE software, which is likely to take a few more months.
     
  3. During the interim, the CPIO will suggest to the senior management to operationalise a simple system whereby the bank would electronically transfer data to the insurance company as soon as the premium is credited to the account of the company and this information would further be electronically transmitted to the TPA thereby eliminating any unnecessary time lag in putting into force the mediclaim policy by the TPA with consequent benefits to the insured.

 

It’s bizarre that the TPA has to physically visit branch office once in a week to get updates on policy renewal or purchase. Even more astonishing is that a simple solution of electronic data transfers between bank to UIIC and then to TPA needed activists like Dr Agrawal to knock on CIC doors. It opened a UIIC Pandora’s Box.

 

Hapless policyholders end up with cashless denial just because UIIC is living in pre-computer age of manually getting cheque credited information from bank and making the TPA show up at the branch doors to get policy renewal information. Not to talk about the delays in TPAs putting this updated information on their computer systems. Till that happens, the policyholder is told that you are not our customer; you will not get cashless and we cannot even take hospitalisation intimation. In short, we may not pay your reimbursement claim as we did not take your hospitalisation intimation.

 

It will have to been seen when the self-revelation of UIIC is actually implemented. UIIC needs to empower the customer with quickly doing what they said at CIC hearing and not just offering M-Power mobile application for premium collection.

 

Read - CIC asks United India Insurance to disclose information that may help close a loophole – I

Read - United India CPIO defies CIC order, gives irrelevant data to RTI petitioner

User

COMMENTS

deepaksb

5 years ago

It’s not UIIC, all other PSU General insurance cos sail in the same boat.Renewal data is not updated with TPAs for months even sometime till next renewal is due. For policies which are couple of years Old and regularly renewed in stipulated due dates, TPA’s asks policy holder for copies/proof of ALL previous year's details. Situation is worse when an insurance co. has changed its TPA.

End sufferer is POLICY HOLDER.I will appreciate if some more policy holders/agents can share above mentioned facts in order to revamp efficiency of these insurance companies and hold them accountable.

At times even IRDA and ombudsman favors TPA and insurance cos. for disputes generated due to above mentioned in-efficiency of insurance cos. and TPAs.

United India Insurance uses mobile tech for collecting premiums but in other ways it is in a pre-computer era!

United India Insurance has launched M-Power so that you can pay your premium by mobile easily. But its technology is so poor that renewal of mediclaim information may not reach the TPA for as much as two months. Also, cashless claim will not be approved during this time. Ease in hospitalisation intimation using SMS is the need, not mobile premium payment

United India Insurance Company (UIIC) was the winner of CNBC TV18 Best General Insurance Provider–Public Sector award declared earlier this week. Maybe it is an outstanding company but customers may have a different view. United India has just launched ‘M-Power’—a mobile application that can be used by customers to pay their premiums using a mobile phone. But, ‘M-power’ is only for raking in premium. There are two major flaws in UIIC’s processes which need to be addressed with simple technology.

 

One, hospitalisation intimation to Third Party Administrator (TPA). United India has set an unrealistic deadline of 24 hours for this. Even this can be made easier for the policyholder if he or she is allowed to intimate the TPA with an SMS; the TPA can acknowledge it with a return SMS and/or a phone call.

 

Two, United India is possibly living in the era of a horse-driven carriage. It may take two months for information about policy renewal to be communicated from the branch office to the TPA. This has come out in a Right to Information (RTI) reply to Dr Anshu Agrawal.  It means that the cashless feature is denied to customer during this period even when policy is renewed. UIIC can easily get “cheque credited” data from a bank electronically and transfer policy data electronically to the TPA. UIIC Chief Public Information Officer (CPIO) told the Information Commissioner that the TPA visits the branch office once a week to get information on mediclaim policies in-force. According to Dr Agrawal, “In an era of net-banking and e-mails, UIIC is living in medieval era.”

 

Of course, it is using mobile technology. But only to collect its premium income, where it has suddenly become tech-savvy.

 

In today’s technology-driven world, how does United India justify a time gap of one to two months for policy renewal information to reach from branch office to the TPA? The company selectively develops mobile technology for premium collection, but the TPA still visits branch office on a weekly basis when customer data could easily be transmitted electronically.
 

A delay of two to two months to give renewal information to the TPA and/or TPAs not updating their systems with renewal information leads to denial of cashless approval under an inexplicable excuse that the customer has not renewed the policy even though the insurer has cashed the premium payment cheque one to two months back—now via mobile. This is nothing less than short-changing the customer. What’s more disturbing is that this can even impact the reimbursement claim.
 

At the launch of ‘M-Power’, media reports quotes G Srinivasan, CMD, UIIC, saying “This is very aptly called M-Power; empowering customers to make their premium payments through mobile phone. I think in the next two years, at least 5% to 7% of our customers will use this platform to pay their premiums.” When asked if they would also look into paying claims through this mode, he said, “That will be the next step”.

 

What it means is that UIIC is more interested in making it easy for itself to collect premium; ease of hospitalisation intimation and filing of claims does not seem to be the priority. After all, paying claims cannot be as welcome as collecting premium. Many times TPAs play dumb about getting hospitalisation intimation by email or say that the fax message was illegible. TPAs also keep you on hold forever or may not be available 24x7, as they promise.
 

Read—CIC asks United India Insurance to disclose information that may help close a loophole – I
 

Dr Anshu Agrawal had a sweet victory in June 2012 when Central Information Commission (CIC) took the liberty of looking at the issue in the larger public interest of the insurance policyholders and not just confined to the UIIC Bareilly office, about which he had complained. The CIC recommended to the chairman and managing director of United India to give directions to all branch managers to put up on the company's website the following information by 16 August 2012: Mediclaim policy number (no names are required to be given), policy date of issue, date of transfer of the said policy to the TPA.
 

Read - United India CPIO defies CIC order, gives irrelevant data to RTI petitioner
 

Stay tuned for the second part of the article which you will be interested to know the latest update on the case. Did United India really comply with CIC order? Where do they stand with respect to Comprehensive Online Real-Time Environment (CORE) software? What are the proposed steps to streamline the process of getting cheque credit information from bank to insurer and then passed to TPA?

User

COMMENTS

Rakesh Goyal

5 years ago

1. Most of the awards are managed.
2. If this is the condition of best (sic) General Insurance company, what other will be?
3. One shit is saying to other that I am more perfumed.

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