Electronic health records
will help insurers and intermediaries to track health history of policyholders which
in turn will lead to better product design and product fitment.
IRDA
has invited suggestions from life insurance companies, non-life insurance
companies, standalone health insurers, TPAs and intermediaries for the implementation
of electronic health record standards (EHR).
EHR
is proposed to work as a uniform system for maintenance of health records
electronically by hospitals and health care providers. Government of India has already
taken initiatives to implement standard protocols like codes for treatment,
diagnosis and diseases.
For
insurance industry, EHR can be used for the purpose of risk management. It will
track the health history of policyholders and help in designing of innovative
products, estimating periodicity of recovery, pricing products appropriately,
studying the groups with similar illness and predicting health behaviors.
Krishnamoorthy
Rao, Chief Executive Officer, Future Generali General Insurance is of the view
that such data will improve transparency and help insurers to design the
products better. Also, it will help policyholders compare treatment cost
incurred for a particular disease in various health centers helping them to
limit their treatment cost as per insurance coverage, he added.
Another
Chief Executive Officer of a mid-sized insurance company who didn’t wish to be
quoted said that IRDA has no control over health care sector and thus the
insurance regulator cannot do much about the implementation of electronic
health record. However, such records can
help insurers design customized low cost products for policyholders by analyzing
the nature of medical history. Also, for intermediaries, it could help them by suggesting
better health insurance plan to their clients with the help of risk profiling
through EHR, he said.
In a
circular, IRDA has said, “Implementation of the EHR will be of immense use for
the insurance companies – both life and non-life including stand-alone health
insurers, TPAs and the intermediaries. Therefore it is advised that the
insurance companies and TPAs should visit the website http://mohfw.nic.in and
provide their suggestions, if any to us at the earliest, so that the same can
be taken up with the government.”
The
software will be made available soon and the implementation process will start
immediately with the help of Centre for Development of Advanced Computers (C-DAC)
Pune, said IRDA.
Source: Team Cafe Mutual