Press Esc to close
Saturday 01 November 2014
News updated at 2:39 PM IST
Weather
Max: 25°C
Min : 19°C
In Bangalore
Partially cloudy

Irda plans better fraud detection tech

New Delhi, Dec 30, 2012, PTI:

Worried over fraud in the health insurance sector, Insurance Regulatory and Development Authority (Irda) plans to build an advanced detection and prevention system to check fraudulent claims.

In order to reduce the cost of insurance inflicted by fraud, Irda said it is proposing to build advanced detection and prevention systems at industry level to identify fraudulent claims before payment occurs and to improve the accuracy of fraud detection.

“Firms/organisations are advised to submit proposal to establish a comprehensive and complete solution for insurance fraud management within health insurance segment...,” Irda said, while inviting bids from eligible agencies for fraud prediction and detection analysis for underwriting and claims.


The regulator said it is looking to develop the system to enable the industry to underwrite the proposals effectively by getting up-to-date information, fraud alerts and medical history from the central database and also price products based on reliable database.

Among other things, the selected agency will have to assist the industry as well as the regulator with alerts related to fraudulent and suspicious transactions including overcharging, unlawful claim, false claims or multiple claims for same event in a particular region.

Further, it intends to minimise cost at industry level by centralising data without individual insurers having to necessarily resort to both software and hardware solutions for the purpose of fraud prevention.

The four PSU insurance firms — National Insurance, New India Assurance, Oriental Insurance and United India Assurance — had in July 2010 stopped the cashless facility in select private hospitals, alleging over-billing.

They had alleged that some hospitals were charging patients who have health insurance policies at rates which are much higher than the normal cost of treatment.

Irda has already constituted Insurance Information Bureau of India (IIB), a central repository of insurance industry data, which  is collecting, processing and disseminating data.

Also, the proposed system aims to assist insurers efficiently manage the claims by getting relevant information on fraud and claim reporting patterns, also ensuring that genuine customers do not face hassles.

Go to Top

Photo Gallery
A view of the statue of Sardar Vallabhbhai Patel on the occasion of his birth anniversary...

A view of the statue of Sardar Vallabhbhai Patel on the occasion of his birth anniversary...

Congress President Sonia Gandhi and Rahul Gandhi paying tribute to former Prime Minister...

Congress President Sonia Gandhi and Rahul Gandhi paying tribute to former Prime Minister...

Artists perform during a function on the occasion of birth anniversary of Sardar...

Artists perform during a function on the occasion of birth anniversary of Sardar...

Members of Thamizhar Vazhvurimai Koottamaippu during a protest against Sri Lankan court's...

Members of Thamizhar Vazhvurimai Koottamaippu during a protest against Sri Lankan court's...

Indian cricket players during their practice session at barabati stadium in Cuttack...

Indian cricket players during their practice session at barabati stadium in Cuttack...

Delhi Police band performs at India Gate near Amar Jawan Jyoti to salute Sardar...

Delhi Police band performs at India Gate near Amar Jawan Jyoti to salute Sardar...

Army soldiers patrolling after an IED was recovered in a gas cylinder near the Circuit House...

Army soldiers patrolling after an IED was recovered in a gas cylinder near the Circuit House...

Tourist take pictures from a boat as people bath in the Ganges river in Varanasi...

Tourist take pictures from a boat as people bath in the Ganges river in Varanasi...

Devendra Fadnavis being sworn-in as the new Maharashtra Chief Minister by Governor...

Devendra Fadnavis being sworn-in as the new Maharashtra Chief Minister by Governor...

A camel herder sits as he feeds his camels at the annual cattle fair in Pushkar, in the Rajasthan...

A camel herder sits as he feeds his camels at the annual cattle fair in Pushkar, in the Rajasthan...

Copyright 2014, The Printers (Mysore) Private Ltd., 75, M.G Road, Post Box 5331, Bangalore - 560001
Tel: +91 (80) 25880000 Fax No. +91 (80) 25880523