Insurance regulator IRDA is working on a centralised mechanism to capture health insurance data with a view to improving the service and preventing misuse of mediclaim benefits by hospitals.
“IRDA is working on a system for capturing data with regard to health insurance systems and entire medical process and billing claims,” a person familiar with the matter said.
The system, the source said, will be aimed at improving health insurance services and also preventing over-billing by hospitals. The health insurance sector is facing problems because of high cost to claim ratio.
The cost ratio for the public sector companies was 140 per cent of the premium received under the health portfolio as on June, 2012.
Apart from other problems, insurance companies had alleged that some of the hospitals were charging the patients having health insurance policies at rates which are quite higher than the reasonable cost of treatment.
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