“Last year (FY 2020-21), our total claims were worth ₹ 1530 crore. This year (FY 2021-22), in just Apri-May we have incurred the claims worth ₹ 990 crore,” said Dr. S. Prakash, MD of Star Health and Allied Insurance.
After the pandemic Insurance companies are going through major changes.
“The health insurance segment is going through a metamorphosis phase. The healthcare system should be far more resilient, more GDP should be allotted here,” he said.
Need of a Health Regulator
Pandemic has aggravated the old debate between the insurance companies and hospitals. Insurance companies have been recommending a health regulator to standardize the hospital rates.
“There is a lot of uproar and uptake on the health regulator .There is a need for a strong regulator in the health sector. The Health Regulator, who can focus on standard operating procedure and standardisation of cost. All these things can help millions of people in India where people are medically ignorant,” he said
Insurance companies and hospitals have been arguing about the hospital rates for more than a decade.
“Insurers cannot be just doing a job of clerk. Insurers should be well equipped about any disease prevalent in the country. Insurers should know the do’s and don’t and should be able to ask the right questions to the hospital to avoid the unnecessary admission and drugs. Today nobody is there to question these areas,” he explains.
He also shares recent examples where hospitals have charged 15,000 for CT scan, which he thinks is difficult for insurance companies to pay.
“We are the custodian of the common fund and we can’t pay such an amount since it’s unreasonable,” he adds.
Changes at Star Health
Insurers are embracing the high end digitization in their daily operations.
“We are going to work more on technological upliftment, digitialisation for continuity of services and providing them fast,” concluded Dr Prakash.