MODALITIES FOR HEALTH INSURANCE SCHEME UNDER DISCUSSION

Chennai: A day after the government announced its decision to extend health insurance cover to the poor, Chief Minister M. Karunanidhi convened a meeting of officials to discuss the modalities of implementation of the project. Emerging from the discussions, he said he had preliminary discussions on the scheme with Finance Secretary K. Gnanadesikan on the method to identify the beneficiaries, financing, floating of tenders and the chronic diseases that needed to be included under the scheme.

“It will take about three to four months for the scheme to be operational,” Mr. Karunanidhi told The Hindu. Since a notification for the general election was expected in between, the government would not be able commence the work on the project. “We will suspend work on the project once the code of conduct comes into force and will recommence after the elections,” he said.

In the discussions, Mr. Karunanidhi felt that beneficiary identification was critical to the scheme and hence the first major task would be identifying them. It was suggested that the government take the database of the Agricultural Welfare Board, which has a list of about 75 lakh members and this could be the start. The government decided to verify the database and involve the district administration in the process of identification of beneficiaries.

While this was on, tenders would be called for from insurance companies to operationalise the scheme and shortlist private hospitals. “Once tenders are called for, we need to give at least 30 days. Within that time period, it is possible that elections are announced. Then, the process will be kept in abeyance till such time the election processes is completed,” an official said.

For now, the thinking in the government is to include only serious ailments for which government sector hospitals in district towns are not able to cater. “We spend about Rs.3,000 crore a year on government hospitals. If we include all diseases, then this investment will go waste,” an official said. With only major diseases included, the government expects the insurance premium to be in the region of Rs.300 crore.

On the question of selecting a firm from among the public sector players in the field, Mr. Karunanidhi said the company was to be chosen after bidding and all procedures under the Tamil Nadu Transparency in Tenders Act would be followed. Also, the firms would have to be approved by the Insurance Regulatory and Development Authority. “We will not be able to prefer a private sector firm or public sector firm in this,” the Chief Minister said.

Source: The Hindu

CII WELCOMES HEALTH INSURANCE SCHEME FOR THE POOR

Chennai: The State Council of Confederation of Indian Industry (CII) on Thursday welcomed the State government move to introduce Health Insurance Scheme for Life Saving Treatments for the poor and low-income groups. Addressing newsmen, Manikam Ramaswami, CII-TNSC Chairman, said “this gesture of Chief Minister M. Karunanidhi will go a long way in not only improving the physical health of the people, but also the financial health as healthcare costs is one of the most important reasons for indebtedness.”

“Besides, it will ensure that Social Development Indices will accelerate faster than Gross State Domestic Product growth rate which alone is sustainable. CII is particularly happy to note that the government has included lifestyle diseases, which is the largest contributing factor to hospitalisation, and high cost of healthcare,” he said. According to Mr. Ramaswami, the idea of preventive healthcare for lifestyle diseases (veedu thedi vandhu varumun kaappom) was mooted at ‘Healthcare for All’ Summit jointly organised by the State government.

As against Varumun Kappom, preventive healthcare for lifestyle diseases is seen as a means to substantially reduce the need for hospitalisation and cover all healthcare costs through an innovative insurance scheme by roping in private healthcare providers in addition to government hospitals. Mr. Ramaswami called for appointment of healthcare worker in the ratio of 1:4000 people to carry out check-up of urine-sugar, urine-salt and blood pressure at doorsteps and inclusion of more number of players under Public-Private-Partnership to give wider choice to employees to select the appropriate insurance scheme.

By February end, CII-TNSC will submit its recommendations to the State government on Employees State Insurance Scheme’s quality of service, its location and the expectation of the employees among other things. The survey was necessitated as most of the employees said that they have spent more than the ESIC money and the services were not satisfactory.

Source: The Hindu

SATYAM RENEWS STAFF HEALTH INSURANCE

Hyderabad: There is a big relief for thousands of employees of the scam-hit Satyam Computer Services across the country on the health insurance front. The Hyderabad-based company has renewed the group health insurance for its employees. According to a Satyam spokesperson, the last date for the payment of the premium was and the company promptly renewed it.

The company has Iffco-Tokio General Insurance Co. as its insurer and TTK Health Care Pvt. Ltd. as the Third Party Administrator (TPA). The renewal premium was roughly about Rs 30 crore. Incidentally, the insurance premium expired at midnight yesterday.
Meanwhile, the company has also said the insurance premium for the Satyamites in the US was paid.
Source: The Hindu Business Line

HEALTH CLAIMS: NON-LIFE INSURERS PLAN THIRD PARTY ADMINISTRATOR

Mumbai: The four public sector non-life insurers – New India Assurance, Oriental Insurance, United India Insurance, and National Insurance – are mulling floating a third party administrator (TPA) company to take advantage of the healthy volumes in the health insurance segment. “There is a case for the four public sector non-life insurers to come together to set up a third party administrator for health insurance due to good volumes in the segment,” said Mr M. Ramadoss, Chairman and Managing Director, Oriental Insurance Company.

An insurance company takes the help of TPA to manage its claims processing and hospital networks. Delhi-headquartered Oriental Insurance Company is planning to set up separate offices to cater exclusively to the needs of brokers, large corporate accounts, retail accounts, bancassurance and dealer tie-ups. The existing offices are being re-designated depending on which business is more dominant in that office. “We are focussing our attention on various segments of the market. Brokers are an important distribution channel and we have set up separate offices to cater to this segment. By March, we should have at least 10 offices catering to the broker segment,” Mr Ramadoss said. The company has also started its first centralised claims service centre in Chennai to service motor-own damage claims.

During the nine months ended December 31, 2008, Oriental’s gross premium has grown by 2.7 per cent to Rs 2,978 crore. It is focusing on reducing its underwriting losses, especially in health insurance claims and motor third-party claims. “We aim to reduce our third party claims in health and motor by 10 per cent and 5 per cent respectively by March-end 2009,” he said. The company is hoping to collect gross premium of Rs 4,000 crore by March 31, 2008.

Source: The Hindu Business Line

ORIENTAL INSURANCE PLANS TO EXPLORE UNTAPPED AREAS

Coimbatore: In order to tide over the declining growth rate of insurance companies, Oriental Insurance is planning to explore the untapped areas to balance the falling growth rate, said M. Ramadoss, Chairman and Managing Director of The Oriental Insurance Company Limited, New Delhi. He was speaking at the function organised for the inauguration of the new premises of the Coimbatore Regional Office.

S. Surenther, Financial Advisor and General Manager were present. The economic slow down had resulted in the growth rate plummeting during the current fiscal from two to three per cent in October, it fell to one per cent in November and till December the overall growth rate had been only three per cent. Mr.Ramadoss said that the overall growth at the end of the fiscal was expected to stagnate at 10 to 12 per cent.

The fall in premium revenue and the resultant drop in growth rate were also because of the review of pricing and de-tariff measures in the premium rates done in April 2007. In the automobile insurance sector, Oriental was planning to come up with premium products such as depreciation free claim, alternate vehicle replacement policy during the period between accident and restoration of the vehicle.

The Commercial vehicle production had plummeted from 55,000 to 17,000 showing a drastic fall in the premium revenue graph. The health insurance sector alone was growing at a rapid pace. Growth in the health insurance sector stood at 55 per cent last year and it had already crossed more than 25 per cent. Out of the Rs 4,000 crore premium income per annum, Rs 550 crore came from health insurance segment alone and this was expected to touch a Rs 850 crore mark during the current fiscal or next, he said. The focus of the insurance industry would be more on this sector, he said.

However, expressing concern at the fraudulent practices, Mr.Ramadoss said that insurance sector was continuously asking the health ministry to standardise treatment procedures at the private hospitals. In the health insurance and motor vehicle insurance sector, the loss ratio incurred in terms of claims settlement was at Rs 120 crore. Owing to sustained efforts to tame the loss, it fell by 10 per cent this year and was expected to fall by another 10 per cent.

Oriental Insurance was also considering the setting up of a centralised claims processing centre which would be assisted by a panel of surveyors. Personal accident policy, house hold insurance policy, burglary protection cover besides inculcating the habit of insurance among younger generation and focusing on untapped rural areas could help balancing the fall in growth, Mr. Ramdoss said. Oriental Insurance has 900 offices and new regional offices are being opened at Hubli, Vizag and Raipur. An overseas branch is being opened at Doha in Middle East, he said.

Source: The Hindu