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Insurance Companies Working on Measures to Speed Up Health Policy Claims

November 29, 2007 at 6:12 PM Health Insurance News
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Insurance Companies Working on Measures to Speed Up Health Policy Claims
Policy holders of healthcare insurance will no longer have to wait a long time for their claims to be settled once measures taken by state-owned non-life insurance companies come into effect.


These companies are involving commercial banks to prevent misuse and diversion of healthcare claim funds by third party administrators (TPAs), say officials of leading insurers.

There have been widespread complaints that TPAs do not issue cheques to claimants on time. They divert the claims funds for other activities, delaying payments to hospitals and policyholders. There have also been instances where cheques issued by TPAs have bounced.

The average time taken to settle a healthcare claim for individuals is anything between a month and 15 days. For hospitals, the TPAs take anything between 45 and 90 days.

While individual policyholders have little recourse, hospitals have started charging differential rates for TPA and non-TPA patients.

In the process, the insurers not only faced flak and footed increased bills but also started losing customers.

The Chennai-based United India Insurance Co Ltd (UI) has stopped providing funds to TPAs towards settlement of claims. It has instructed its bankers -- Bank of America and CitiBank -- to issue cheques in the name of hospitals on receipt of claims data from TPAs.

"Under the new system, the TPAs would upload the critical data after processing the claims. The two banks would make out the cheques in the name of the hospitals and send them to the TPAs for onward transmission to claimants," V. Sekar, general manager, UI, told IANS.

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More News on: Health Insurance - Basics, Third Party Administrators for Health Insurance, Awareness about Healthcare Insurance in India, Fraudulent Health Insurance Claims, Cholamandalam MS General Insurance Co. Ltd, United India Insurance Company Limited, An Introduction - Indian General [Non-Life] Insurance Companies, Healthcare Insurance-Common Terms and Definitions, Tata AIG General Insurance Company Ltd, Royal Sundaram General Insurance Company Limited
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