Mumbai: Health insurance in India currently covers only around five per cent of the total spending in the healthcare sector. This should at least increase to 20 per cent, said Mr J. Harinarayan, Chairman, Insurance Regulatory and Development Authority of India, while addressing the CII Health Insurance Summit.
“Insurance companies’ payout, allowing for a 100-105 per cent claim, is only around Rs 5,000 crore as against the total health care spending of around Rs 1,70,000 crore,” Mr Harinarayan said.
Of the total health care spending, Rs 1,00,000 crore is for outpatient treatment (non-hospitalisation) and Rs 70,000 crore for hospitalisation expenses.
IRDA is building a repository of data on holders of health and motor transport insurance policies.
“The database should be operational before the end of this financial year. The reporting format has been finalised. Only, the physical hardware remains to be established. IRDA has designated the Tariff Advisory Committee as the data repository for the non-life insurance industry in India,” Mr Harinarayan said.
With the standardisation of health insurance policies, seven million health records will be available in public domain, he said.
The regulator emphasised the need to improve the claims settlement process. At present, 70-75 per cent of the claims are settled within a year. He underscored the need for third party administrators and insurance companies to build IT-based systems and establish their own systems to address consumer grievances.
The IRDA chief said insurance companies could issue insurance policies in regional languages in the interest of policy holders.
He also highlighted the role of third party administrators in improving the communication between hospitals and insurers.
