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Working with health insurers for 100% cashless medical claims: IRDAI Chairman

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Working with health insurers for 100% cashless medical claims: IRDAI Chairman

Insurance Regulatory and Development Authority of India (IRDAI) is working with players in the health insurance ecosystem to ensure 100 per cent cashless settlements for medical expense claims, which would eliminate the need for filing claims, said Chairman Debasish Panda on Tuesday.

“The councils — industry bodies Life Insurance Council and General Insurance Council — are playing a very prominent and active role for enabling common empanelment and interoperability with hospitals. This will make claim processing of health insurance seamless and frictionless for the policyholders,” said Panda at the Global Fintech Fest 2023.

IRDAI is also working closely with the National Health Authority to onboard more hospitals onto the National Health Exchange, and with insurers to ensure better and more affordable products for senior citizens, as the current pricing makes medical insurance inaccessible for most people in this segment.

The regulator is also working to launch products and features such as long-term general insurance, flexible policies, and is encouraging new and niche players to deepen reach and accessibility of insurance products.

Also read: Why corporate health insurance should only be a secondary line of defence 

“We are looking at long-term products in property and motor, P&I (protection and indemnity) clubs, insurance for warehouses and non-performance insurance,” said Panda, adding that the proposed amendments to the Insurance Act will also help create a more robust, facilitative and supportive insurance landscape.

“We may see new players in the form of micro, captive, regional, specialised, composite insurers catering to the needs of different geographies and strata of the populations,” he said, adding that there is a need for more value-added services and flexible products, including in the annuity and retirement space.

New risks

Panda said there is a need for players in the insurance sector to deal with new types of risk, such as climate change, pandemics and cyber security, saying that the next 10 years will see radical changes in terms of the nature of insurance products and the way they are distributed.

He also touched upon the the ‘Bima Trinity’ being developed by the regulator which includes a simple benefit-based product ‘Bima Vistaar’ to be distributed by localised women-centric distribution force under ‘Bima Vahak’. Further, these insurance products would be sold on the regulator-backed unified electronic market place ‘Bima Sugam’.

Panda also announced the launch of the first quantitative impact study to develop the proposed risk-based solvency framework of the sector to enhance the industry’s risk management practices, and establish mechanisms to develop processes for a smooth transition for the industry.