The forum would facilitate evolution of regulation in the health insurance industry.
IRDA is planning to create a health insurance forum for enhancing an effective dialogue between the service provider (hospitals), the insurers and the third party administrators (TPAs). The forum will play a consultative role to enable the evolution of the regulatory structure.
The forum would eventually turn into an SRO. This move has been taken by IRDA after it observed reluctance among the health insurance participants to evolve the health insurance industry. “All health insurers are facing some problem with the hospitals or TPAs while settling claims. Therefore, all of us are trying to put in place a certain process for cashless mediclaim and other mediclaims. This will help make it a hassle free process for all. This forum that will make our work easier and lead to smooth running of the industry,” said Krishmoorthy Rao, CEO and MD, Future General Insurance.
The members of the forum would include three CEOs of health insurance companies, three CEOs of life insurance companies, CEOs of two TPAs, an official from labour and health ministries, an official from ministry of health and family welfare, chairman of NABH, superintendents of two government hospitals, one representative from standalone insurance company, ED/JD (health) IRDA and one representative from IRDA representing consumers.
Nimisha Srivastava, senior assistant director, IRDA shall play the role of the convener and member secretary of the forum. The function of the forum would be as follows:
a) To assist IRDA in evolving regulations relating to health insurance business in India
b) To facilitate creation and adoption of standard processes in health insurance industry
c) To aid, advise and assist IRDA in collecting, maintaining and disseminating data required for the efficient conduct of health insurance business
d) To act as a consultative forum between the insurance companies and other stakeholders
e) To advise IRDA in developing regulations for rendering health insurance forum more effectively
The forum is expected to meet twice a year and more often if the members feel it necessary. IRDA feels that this move will help in smooth running as well as evolution in the health insurance industry.