Increase insurance cover: Panel

A parliamentary committee has recommended that the Universal Health Insurance scheme should be made applicable to the lower middle class and people just above the poverty line.

It has also said that the government should study and implement an Irda suggestion that wanted the money paid by insurance companies for treatment of an insured person to be routed to a separate account in the concerned hospital's books.

The committee on public undertakings attached to the ministry of finance also expressed concern over hurdles in the emergence of standalone health insurance companies.

It further criticised the collusion of health service providers, insurance companies and third party administrators (TPAs) in wrongful settlement of claims.

Pointing out that only 10 per cent of the country's population is covered under some sort of health scheme, the panel asked the government to make health service providers accountable.

It pointed out that an additional burden had been thrust upon the insured by increasing the premium costs by 6 per cent to meet the cost of service rendered by TPAs.

TPAs who are involved in underwriting and presenting claims lacked the competence and necessary infrastructure to fulfil the role expected of them.

The committee called for implementing the IRDA's recommendation to enable TPAs effectively manage and settle claims. It also recommended setting up of a pilot health insurance scheme in a time-bound manner.

It asked the government to set ambitious targets for public sector insurers in terms of covers sold and strictly monitor the targets.

Public sector insurers did not make efforts to cover large chunks of the population under health insurance schemes in absence of any targets in terms of the number of covers sold.

To boost infrastructure for health insurance, the committee recommended that state governments may be requested to allot land at concessional rates to private bodies, self-help groups and co-operatives for development of health infrastructure in rural areas.

Stressing the need for adequate data on morbidity, demographic groups and diseases, the panel recommended expeditious implementation of the roadmap submitted by the IRDA's internal working group on health insurance.