Shreeraj Deshpande,
Head – Health Insurance,
Future Generali India Insurance Company Ltd
Shreeraj Deshpande, Head – Health Insurance, Future Generali India Insurance Company Ltd, talks to Monalisa, ENN, about the growing role of IT in health insurance sector
What are the most pressing challenges for health insurance companies in India?
The most pressing challenge is the unregulated healthcare sector in the country. There is no uniformity in the healthcare sector. The insurance industry and the regulator have taken steps towards standardising definitions, formats, etc, among the insurers. Now there is a need to have some sort of regulations in the healthcare sector and also some amount of uniformity among the healthcare providers such as uniform billing patterns, uniform discharge summaries, procedure codings at hospital levels, etc. The other major challenge has been growing the retail health insurance business.
How can Information Technology help address these issues?
IT sector has a very major role to play in the health insurance sector. The health insurance business involves a lot of data collection, collation and data transfer between various stakeholders such as insured, corporate, insurance companies, TPAs, hospitals, etc. This data is also a very sensitive and confidential. How smoothly and effectively such large volumes of data can be handled and transferred is the key for successful operations in a health insurance business. There is a need for uniform single platform over which data exchange can take place between the various stakeholders. Even claims settlements can become faster with electronic transfer of data from hospitals to insurance companies/TPAs.
How can IT help insurers manage multiple formats of data that result from customised health insurance plans for enterprises?
Insurers need very flexible IT software to take care of such variations in customised healthcare plans. Today this is a very big challenge where the available softwares are more rigid in their approach and find it very difficult to cater to such tailor-made requirements. The idea is to have software which help in customisation, but also have validations built into the same and come out with excellent MIS reports which would help the insurers in pricing, detecting frauds, controlling claims, as well as operations. Data Analytics and IT tools should either be in-built or be plug-ins into the base softwares.
What technologies have you adopted recently and in what ways have they impacted operations?
Our health insurance vertical includes all processes such as underwriting, enrolments, claims as well as customer service. We have an exclusive e-health module where corporate employees can log in and enroll, add dependents, print cards, download forms, see the status of their claims, cashless, find hospitals, etc. We have all proper documented processes and the KPIs are measured and tracked on regular basis. We make neft payments to our hospitals as well as clients for their claims. We scan all our claim documents and archive the same which helps in proper storage and recovery at any time.
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