Insurance Companies compromising with interests of Healthcare insurance customers
Four public sector insurance companies have formed a grouping called GIPSA. GIC was dissolved so that these four insurance companies compete with each other but these companies still continue to operate as illegal grouping. They are doing empanelment of hospitals in a completely arbitrary and non transparent ways, promoting a cartel of providers and hence limiting the options for patients.
These companies are playing with patient care also by fixing packages to maximise their own profit , compromising the consumer rights of insured . Same package is offered at a hospital for insured having different coverage. Situation is becoming worse from bad as GIPSA Insurance ecosystem is completely non transparent, new hospitals are not given entry into exclusive grouping.
Ideally all hospitals registered with state health departments , should be offered unconditional empanelment, if they seek empanelment as health is a state subject and most states have legislative acts for registration of Medical establishments. Even there is a Clinical Establishments Act 2010, passed by Indian Parliament but these insurance companies don’t value standards set by legislative assemblies and Indian Parliament and have set a corrupt & completely non transparent system of providers network.
All these companies act in collusion and hence limiting the options for patients to select their healthcare providers. These companies are also meddling into affairs ,like quality of healthcare, type of healthcare of an insured without accepting their own accountability.
IRDA is well aware of this GIPSA grouping of four public sector insurance companies but conveniently forgets its statutory responsibility to act against this illegal group of companies engaged in same business.
Complaints with IRDA india has not yielded any favourable results. IRDA instead of acting against these insurance companies for not widening providers network , is supporting this strong cartel of insurers, TPAs and providers . IRDA brought a circular making NABH accreditation compulsory for cashless to further reduce the providers base and promote a lobby of big hospitals. There is a systematic efforts to marginalise small healthcare establishments, which do a balancing act in pricing of medical services . more
These companies are playing with patient care also by fixing packages to maximise their own profit , compromising the consumer rights of insured . Same package is offered at a hospital for insured having different coverage. Situation is becoming worse from bad as GIPSA Insurance ecosystem is completely non transparent, new hospitals are not given entry into exclusive grouping.
Ideally all hospitals registered with state health departments , should be offered unconditional empanelment, if they seek empanelment as health is a state subject and most states have legislative acts for registration of Medical establishments. Even there is a Clinical Establishments Act 2010, passed by Indian Parliament but these insurance companies don’t value standards set by legislative assemblies and Indian Parliament and have set a corrupt & completely non transparent system of providers network.
All these companies act in collusion and hence limiting the options for patients to select their healthcare providers. These companies are also meddling into affairs ,like quality of healthcare, type of healthcare of an insured without accepting their own accountability.
IRDA is well aware of this GIPSA grouping of four public sector insurance companies but conveniently forgets its statutory responsibility to act against this illegal group of companies engaged in same business.
Complaints with IRDA india has not yielded any favourable results. IRDA instead of acting against these insurance companies for not widening providers network , is supporting this strong cartel of insurers, TPAs and providers . IRDA brought a circular making NABH accreditation compulsory for cashless to further reduce the providers base and promote a lobby of big hospitals. There is a systematic efforts to marginalise small healthcare establishments, which do a balancing act in pricing of medical services . more
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It is not the IRDA but the fault lies with the Government and its Ministers who are not interested in Public welfare as they look the chunk of money they are getting from them in form of Advertisement & campaign cost for them and thier Party more
Dec 29
IRDA has proven to be one of the worst regulators in India. There are so many problems in the insurance sector, there is rampant mis-selling of insurance policies by the agents and policyholders are cheated with their hard earned money and there is hardly any smooth remedy for the same. I do not understand why IRDA should be allowed to act independently and as an autonomous body with taxpayers money, when it has failed to regulate an important industry/ sector like the 'insurance' sector. Insurance is an important sector and if the regulator is not effective then I think govt. must take steps immediately to bring an effective robust regulator for the sector, or else it might be too late to act. more
Dec 25
Health Insurance are taken by people for Medical emergencies and while getting admitted they go as per the List of Health Care Providers listed in their Panel as per each Insurer's designated TPA . United India /National Ins/ New India Ins under Govt PU's are being blamed without mentioning the other Pvt Sector majors like ICICI Lombard/ HDFC GC/Relience/ Nippon Daichi , etc, whose premium itself is very high compared to Govt Insuerer for Group HEalth coverage . How do you state that most of the small but Good Hospitals are not in TPA's list of PSU Insurer's? What about Pvt Sector Insurers? Make it more clear for us to understand and compare while subscribing. There is clause of "Pre-existing illness" declaration even during renewal and General Public are not clear on this term as most of life style deceases nowadays are developing slowly with age and time . Can BP/Heart/Diabetic/Bone Joints ,etc be considered as what in such declaration, as it gets detected on periodic checkup as we start ageing . Please throw some light on this "pre-existing" term more
Oct 28
