Insurance regulator Insurance Regulatory and Development Authority of India (IRDAI), on Monday, asked health insurers and health providers to raise the bar on “claim settlements”, stating that a disproportionately large number of complaints to the regulator are related to health policies.

Quick settlement

Insurance companies and health providers must practice the highest standards of ethics and ensure that claims are settled quickly and grievances minimised, said Subhash Chandra Kuntia, Chairman, IRDAI, at a FICCI conference on health insurance. Kuntia also urged health insurance companies to keep insurance policy wordings simple and understandable to the general public.

“This is one major area of concern. Many people realise afterwards at the time of making claim that certain things are excluded and feel they could have bought other products. We need simple products for the general public,” he said.

Misunderstanding should also be avoided when it comes to health insurance policies, he said. “There is huge potential for growth. We must grow sustainably, and we must grow in such a manner that all stakeholders benefit together. We cannot think of quick gain at the expense of somebody else. Clients must benefit, otherwise businesses will not sustain,” he added.

Affordability issues

Kuntia also felt that health insurers should look into the affordability of policies. “We need to change the landscape of health provision in the country so that availability of health services to common people can be realised,” he said.

Health insurance industry should promote wellness in a big scale through incentives. “If engagement with policyholders gets intense, we should be able to make a dent in the health situation in the country,” he said.

Related Topics
comment COMMENT NOW