Health insurers see cost in in-house conclusion of claims
Growing discontent in the colonies claims (medical bills and insurance customers) has forced health insurance companies to re-look at their models for the settlement of claims.
Health insurance companies use to outsource their solution requirements agency called third-party administrators (TPA). This was done to reduce costs and time and help insurance companies focus on their heart of business.
The economy and praised the speed of operations in which they would bring did not happen. Now, after several years of unsatisfactory experience with these agencies, insurance companies are back to do these things on their own. Go to the house is the name of the game now.
Health cards did not arrive in time, the delay in question without cash, delays in payment of debts, some of the most common complaints that the insured against any claims by TPA, experts say in the insurance sector.
For the Future Generali, customer complaints have gone to 80 % after moving to the demands of internal models in November 2010.
“Customer service is the point of touching the most sensitive to any insurance company. It is an essential activity for the company, which ideally should not be outsourced. There is also much more accountability with its own units of settlement of the claim because they offer end to end solutions to health insurance, “said TA Ramalingam, head-underwriting, Bajaj Allianz General Insurance.
Direct Connect, an important
I agree with Mr. Sanjay Datta, head-Client Services, Health and Motor, ICICI Lombard General Insurance, “It’s important for us to have direct contact with our customers.”
Insurance companies also say that the claims could be resolved more quickly if you did.
Time claims fell by 50-70 % (as applicable) to ICICI Lombard because it has changed the process in-house in 2008.
“Now, decisions are made directly to us, and also the resolution of disputes is much faster than dealing with customers and directly to hospitals,” said Shreeraj Deshpande, Director, Health Insurance, Future Generali Insurance.
“In-house claims settlement is faster, because there is no link in the client and the insurance company. Benchmark in the sector is about 6-8 hours to accept the request without cash, while the approval of our team -supports will house only 40 minutes, because we process the image, adds Mr. Ramalingam.
Administrative expenses
Claims, the house can lead to an increase in administrative costs than the insurance companies must commit to a solid foundation for the work to link with hospitals, and maintains a 24×7 call center, among other things. However, in the long term, experts believe that it would help to lower insurance premiums.
Source: thehindubusinessline
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