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Policy tonic for health insurance

New Delhi, Feb. 19: The insurance industry regulator plans to come out with guidelines for third party administrators (TPA) who handle medical insurance claims in an attempt to bring about transparency and boost the health insurance business.

The Insurance Regulatory Development Authority (IRDA) intends to issue fresh TPA regulations asking them to follow formats that would help process meaningful information, IRDA chairman N Rangachary said today.

Addressing the fifth global conference of actuaries organised by Ficci, Rangachary said the new guidelines would be in line with the standardised data collection followed in other developed countries, though an attempt will be made to have an Indian version.

He stressed that the lack of proper medical data is the most critical lacuna in the health insurance sector. “We, in the authority, have taken steps to see that data availability is ensured at least prospectively.”

Rangachary said by the end of March, IRDA may notify a regulation laying down standardised forms and details that the TPAs would have to furnish to the authority. “We intend, therefore, to apply indirect pressure on the providers to fall in line with a system to which they are not used to now,” he said.

The IRDA hopes that pension reforms for the large unorganised sector will shortly come into place. Rangachary said: “IRDA had submitted a report on pension reforms to the government in October 2001. The discussion is still on. But a decision will be taken soon.”

The insurance companies have been requested to be more active in designing and selling pension policies, said Rangachary.

“I am conscious of the fact that a life policy leading to pension does not give that manoeuvrability and freedom on maximisation of pensions. But as things stand today, this is the only practical solution that the regulator has to develop a pension market in this country,” he added.

Expressing concern over the fall in interest rates and the rise in longevity rates, Rangachary said, “Pension policies are under stress. It is now that the ability, expertise and experience of the actuaries will be tested.”

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