The Insurance Regulatory and Development Authority of India vide its notification dated 10th June 2020 has directed the general and health insurance providers registered with IRDAI rendering health services to disclose the qualitative and quantitative parameters of the health service rendered to their policyholders.
As per the guideline, the insurers transacting health insurance business should disclose the turnaround time (TAT) for cashless claims for individual/group policies and number of policies and lives serviced along with the geographical area in which services are rendered by the company or its third-party administrators and settlement or repudiation of claims for individual/group/government policies.
The insurers will also have to make public the data about the grievances received against TPAs.
Further, this information shall be published within a period of 90 days from the close of every financial year. The third-party administrators shall provide the link of every insurance company where the said information is available. The Circular shall come into effect from 31 March, 2020 and data for the the FY 2019-20 shall be published by 30 September, 2020 in the provided format.
Click here to download the notification.
