India is considering wide-ranging reforms of health insurance to boost transparency and hold down some of the highest medical inflation in Asia, according to sources. The reforms aim to standardize treatment rates and coverage, making it easier for policyholders to understand what is covered.
Reform Recommendations
A panel of regulators, industry leaders, hospitals, and the Confederation of Indian Industry (CII) group is expected to provide reform recommendations by the end of the year. The panel is chaired by the chief of the Insurance Regulatory and Development Authority of India (IRDAI). The sources, who are directly familiar with the matter, said that the idea is to benchmark treatment rates agreed between insurers and hospitals to reduce disputes and fraudulent claims.
Industry estimates suggest that 10% to 15% of health claims are unwarranted or fraudulent. The reforms also envision a common health insurance product that all insurers will be required to offer alongside existing plans, aiming to standardize coverage and rates for a range of illnesses and procedures.
A uniform list of admissible treatments could also be included, making coverage provisions easier for policyholders to understand. The committee will also push for wider adoption of the National Health Claims Exchange, a platform developed by India’s health ministry and the insurance regulator.
Original reporting: Appleton, WI News Feed (HLL/CB) — read the source article.
