Electronic health records will help insurers and intermediaries to track health history of policyholders which in turn will lead to better product design and product fitment.
IRDA has invited suggestions from life insurance companies, non-life insurance companies, standalone health insurers, TPAs and intermediaries for the implementation of electronic health record standards (EHR).
EHR is proposed to work as a uniform system for maintenance of health records electronically by hospitals and health care providers. Government of India has already taken initiatives to implement standard protocols like codes for treatment, diagnosis and diseases.
For insurance industry, EHR can be used for the purpose of risk management. It will track the health history of policyholders and help in designing of innovative products, estimating periodicity of recovery, pricing products appropriately, studying the groups with similar illness and predicting health behaviors.
Krishnamoorthy Rao, Chief Executive Officer, Future Generali General Insurance is of the view that such data will improve transparency and help insurers to design the products better. Also, it will help policyholders compare treatment cost incurred for a particular disease in various health centers helping them to limit their treatment cost as per insurance coverage, he added.
Another Chief Executive Officer of a mid-sized insurance company who didn’t wish to be quoted said that IRDA has no control over health care sector and thus the insurance regulator cannot do much about the implementation of electronic health record. However, such records can help insurers design customized low cost products for policyholders by analyzing the nature of medical history. Also, for intermediaries, it could help them by suggesting better health insurance plan to their clients with the help of risk profiling through EHR, he said.
In a circular, IRDA has said, “Implementation of the EHR will be of immense use for the insurance companies – both life and non-life including stand-alone health insurers, TPAs and the intermediaries. Therefore it is advised that the insurance companies and TPAs should visit the website http://mohfw.nic.in and provide their suggestions, if any to us at the earliest, so that the same can be taken up with the government.”
The software will be made available soon and the implementation process will start immediately with the help of Centre for Development of Advanced Computers (C-DAC) Pune, said IRDA.