By PTI | 28 Jun, 2015, 12.10PM IST
MUMBAI: In a bid to check rising
instances of fraud, insurance regulator Irdai plans to bring in more stringent
regulations by standardising health insurance products.
The regulator feels that health insurance is
picking up very fast, and so are fraud activities.
"We at Irdai do believe that health
insurance is picking up very fast, but so is the fraud," the newly-joined
member (finance), Irdai, Vijayalaxmi Iyer told PTI.
"We are coordinating with all the
research bodies like laboratories, diagnostic centres and hospitals to
establish standard norms for various services which are part of the health
insurance segment," she said.
It has been put on the Irdai website asking
for opinions from all related stakeholders, she said.
"After completing the procedures, we will
send them for the approval of the Irdai board," Iyer, who recently
superannuated from Bank of India as chairperson, said.
She further said the regulator is
likely to come up with a new set of regulations for the health insurance sector
within the next few months.
"The idea is to bring about an orderly
and sustainable growth in the industry."
The health insurance industry has generated Rs
20,442 crore in premium business in fiscal 2015.
In the forthcoming regulations, Irdai is
likely to focus on features of the product, greater transparency and disclosures
in sales literature and disclosures on web portals to disseminate suitable
information for decision-making.
The regulator is also
planning major changes to health insurance, which include incentives for
healthy policyholders and a level playing field for life and non-life
insurers.
In its new draft rules
for health insurance, the regulator has also said there could be higher
solvency requirements for the the group health segment.
At present, 150 per cent is the solvency ratio
required to be maintained by insurers at all times.
It also plans incentives like more attractive
premium rates for healthy policyholders.
Existing rules do not allow pricing to be
linked to fitness levels as there's apprehension about the availability of
data.
But insurers already offer health and wellness-based
incentives to individuals, including spa coupons, gym membership discounts etc
to encourage healthy behaviour among customers.
Irdai has also
proposed that health insurance claims processing agencies should mandate
hospitals to reflect the negotiated discounts on the bills so that the
policyholders are aware of the actual rates.
That apart, the regulator has also proposed a
minimum paid-up capital of Rs 5 crore for third-party administrators and a minimum
working capital limit of Rs 1 crore.
(From Economic Times)
Courtesy: C H Mahadevan