Central and state governments, the insurance regulator, insurers and hospitals are moving towards a standardization of COVID-19 remedy costs, Atul Sahai, president and chief executive of New India Insurance, told Preeti Kulkarni, also chairman of the General Insurance Council, in the exclusive interview.
What does New India delight in business management in the first quarter of 2020-2021?
The 3 months (April-June) were quite difficult. The industry shrank from nine to 10 according to the penny, New India grew from about 6 according to the penny. We didn’t see any decreases in the 3 months. So we’re pretty pleased that we’ve challenged the trend. With the exception of the engines, the air force and the navy, we did well. Vehicles are now not sold, cargo is not moving and aviation is heavily affected, so those 3 segments are affected. On the other hand, non-public injuries, health, goods and diverse goods are developing for us.
What were New India Insurance’s demanding situations in COVID-19 claim processing?
We have maintained a smart time frame for claims settlement. We proactively contact customers, creating portals and email identifiers, to allow them to submit their claims online. We get on average over 1,500 requests consistent with the day and respond to all. In terms of claims, we have won more than 9,000 claims to date. Of these, we have extended cashless services in more than 90% of cases so far, they have been resolved almost immediately. The others are claims and, even in such cases, we have resolved 50 percent of patient claims. Others are still in the hospital. In some cases, we’ve even made upfront payments.
What is the duration of COVID-19 claims for New India?
Now it oscillates around Rs 1.1 lakh. Initially, it was around Rs 1.3 lakh. The length began to shrink over time. Initially, the load of EPI kits and disposable products was high, but the government encouraged brands to increase production. As a result, value has declined, thanks to a greater source and economies of scale. This has also led to relief in the duration of claims.
IRDAI has asked insurers to take action against hospitals that reject cashless services while they are part of the network. What do you revel in with hospitals?
We are a previously established company with a similar supplier network (PPN). Overall, 90% of our claims were settled without cash. Respondents want strong communication channels to gain a greater understanding with hospitals. In our case, our officials were in constant contact with hospitals and policyholders regarding any type of claim. There may have been out-of-place cases of unethical behavior in the component of some hospitals, but we cannot generalize. We recorded more than 9,000 court cases, but won only 58 to 59 court cases similar to various issues. Even those were quickly removed, because we made sure there were no interruptions in communication.
But disputes between hospitals and insurers about the standardization of safe charges, the addition of PPE kits and sanitation costs continue…
PPE kits were loved at first; What could hospitals have done? The only facet is the use of these kits: if they were used from 5 to 10 for a single patient, then it is not fair. But thanks to our PPN experience, we were able to resolve all those disorders quickly. Another credit for public sector insurers is the network of external directors, which has strengthened our efforts. They are professionals and have helped PSU insurers deal well with this problem. We were able to manage the volume and complexity of the files.
Can we expect a consensus on standardization soon, after discussions between the GI Council and hospitals?
We are in discussions We are looking to achieve some consistency in the charges. Hospitals have reported their problems. IRDAI, the central and state government, insurers and hospitals are running it. We hope a consensus will emerge.
But will all hospitals conform to the General Insurance Council’s rate table?
IG Council price lists are not binding, but are indicative. Wherever hospitals qualify the most, they will have to explain. Insurers do not seek to make a decision about what type of remedy a COVID-19 patient wants or how many days they want to stay in the hospital. It’s up to the doctors. But we have doctors on our General Insurance and APD Council. They may have a say in the rates that hospitals charge for a specific type of room, EPI kit fees, and other consumables. They will not comment on drugs and repair procedures: it is up to hospitals to make a decision.
But where does that leave policyholders who see deductions on the amount of their claim? What’s wrong with them?
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