To bring state govt schemes under purview

The Insurance Regulatory and Development Authority (Irda) is talking to various state governments in a bid to bring their social health insurance schemes under its supervision. State governments that have implemented the schemes for people living below the poverty line include Andhra Pradesh, Haryana and Tamil Nadu.

Irda member R Kannan said that while the states’ schemes have helped increase the penetration of health insurance in the country to 15 per cent, they are not regulated and managed. “There is no single agency to monitor the claim settlement and no proper records maintained in these schemes,” he said.

In Haryana, the Rashtriya Swasthya Bima Yojana (RSBY) insurance scheme was launched in five districts. The scheme provided smart card-based cashless health insurance cover up to Rs 30,000 to all BPL families for five years. The insurer got a premium of Rs 15 crore from this scheme. Similarly, the Andhra government introduced insurance cover for people living below poverty line. So far, the government had insured 6.5 crore people in the state.

The governments of Haryana and Andhra Pradesh awarded their schemes to Chennai-based health insurance company Star Health and Allied Insurance Company. The insurer is getting Rs 350 crore in premium from the Andhra Pradesh government alone, while the Tamil Nadu government has allocated Rs 200 crore for its proposed health insurance scheme called ‘Chief Minister Kalaignar’s Insurance Scheme for Life Saving Treatments’, which is likely to be launched in June this year.

The Tamil Nadu government’s scheme would enable around one crore people living under poverty line to receive free specialist treatment up to Rs 1 lakh for 51 life threatening diseases. The premium would be paid by the government itself. Government has invited tenders from the insurance companies to implement this scheme.