IRDA vows streamlining of health insurance

25 Jan 2012

The union health ministry is in the process of finalising the standardisation of 100-odd procedures related to insurance for hospital treatment, according to Insurance Regulatory and Development Authority chairman J Harinarayan.

After motor insurance (in which it recently instituted reforms) IRDA has identified health insurance as the biggest loss-maker for insurance companies.

Speaking at a seminar on healthcare insurance here on Tuesday, he said streamlining the procedures would help determine the costs and practices pertaining to each medical intervention so that the insurance companies could decide on hospital costs while settling claims.

While the regulator is contemplating setting up a health council or a health advisory committee to bring better discipline and protocols in recovery of hospitalisation costs, it is very difficult to choose a truly representative body due to the complex nature of the health infrastructure in the country, he said.

The country has about 80,000-odd medical establishments, of which 30,000 are in the government sector, ranging from maternity hospitals to multi-speciality and disease-specific hospitals, according to him.

The regulator would be issuing an approach paper on mental illnesses in the hope of bringing these diseases too under the health insurance cover – currently, insurers refuse to cover mental illnesses. Earlier, the regulator had issued a similar approach paper on HIV.