The Insurance Regulatory and Development Authority of India (IRDAI) wants insurers dealing in health covers to make public details on the qualitative and quantitative parameters of the services rendered to their policyholders.
IRDAI said all general and health insurers rendering health services, both through third-party administrators (TPAs) and/or in-house, need to publish the information within 90 days after the close of every financial year. The directions come into force with immediate effect, D.V.S. Ramesh, General Manager (Health) of IRDAI said. Consequently, the first set of data pertaining to the year ended March 31, 2020 will have to be published by September 30.
Figuring in the list of disclosures would be information on outstanding numbers of claims at the beginning of the year; number of claims received, paid and repudiated during the year; and claims outstanding at the end of the year. Details of the turn around time (TAT) for cashless claims as well as for payment/repudiation of claims would also need to be shared.
Policyholders desirous of knowing the details shall be able to access all the information on visiting the website of respective insurer or the TPA, the insurance regulator said.