Press Esc to close
Tuesday 30 September 2014
News updated at 11:21 PM IST
Weather
Max: 31°C
Min : 21°C
In Bangalore
Sunny day

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
Players of Kerala Blaster football team pose for a group photo with Kathakali Dancers in Thrissur ..

Players of Kerala Blaster football team pose for a group photo with Kathakali Dancers in Thrissur ..

Barack Obama and Narendra Modi, at the dinner hosted in his honour, at the White House ...

Barack Obama and Narendra Modi, at the dinner hosted in his honour, at the White House ...

Actors Vikram and Karthi participating in a fast to protest Jayalalithaa's conviction ...

Actors Vikram and Karthi participating in a fast to protest Jayalalithaa's conviction ...

Lahore Lions skipper Muhammad Hafeez is bowled during the Champions League Twenty 20 ...

Lahore Lions skipper Muhammad Hafeez is bowled during the Champions League Twenty 20 ...

Congress Vice President Rahul Gandhi provides relief packages to a flood victim in Jammu ...

Congress Vice President Rahul Gandhi provides relief packages to a flood victim in Jammu ...

Modi waves to supporters  in front of the Indian Embassy in Washington ...

Modi waves to supporters in front of the Indian Embassy in Washington ...

People enjoy a sheep fight in Hubli, Karnataka ...

People enjoy a sheep fight in Hubli, Karnataka ...

Chief Minister of Assam Tarun Gogoi interacts with flood victims at a relief camp at Boko ...

Chief Minister of Assam Tarun Gogoi interacts with flood victims at a relief camp at Boko ...

Products made out of waste materials by the students of a college in Rohtak ...

Products made out of waste materials by the students of a college in Rohtak ...

India's Sunil Vitalacharya Sowmarpet and Akashdeep Singh celebrate their victory over South Korea ..

India's Sunil Vitalacharya Sowmarpet and Akashdeep Singh celebrate their victory over South Korea ..

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