P814-PROGRAMME ON
CLAIMS MANAGEMENT (HEALTH INSURANCE)
(NON-LIFE)
Background
Health was
always important. But the WHO initiatives and the UN Sustainable Development
Goals could not achieve what Covid-19 did for ‘Health’.
Ø
As
far as the state actors, regulators and insurers are concerned, the pandemic
put the focus back on ‘People’: there is increased concern and agility the
world over regarding insurance protection gap, and ‘Health’ dominates
there.
Ø
As
far as ‘People’ themselves are concerned, the pandemic has made them
conscious of the need for protection around happiness, wellness and health.
It’s precisely
for the same reasons that the Health LOB [with 35% plus share in the overall
non-life insurance GWP pie] has become the leading line of business in India.
This - combined
with technological and medical advancements as well as the widening protection
needs of the insuring population including those of the aware and strident
millennials - has made Health Insurance a fertile field for feature play and
innovation.
Given the above,
Health Insurance Claims Management becomes a delicate domain where failure is
not simply an option. It already was a muddled turf with moral hazard, multiple
stakeholders, medical inflation, and the consequent margin pressure.
It’s a Catch-22 situation now. Health is where the top-line traction
is. Claims Management will decide whether prospects are sealed or severed. It
will decide whether business is fetched or forfeited. For the concurrent goals
of penetration and profit, health claims management will have to do a continual
tight-rope walking.
The
captioned programme will help participants in approaching and doing the
requisite balancing act with information and incisiveness.
Objectives
and Contents
The
programme aims to equip participants’ comprehension and increase exposure to
understand:
Ø
Governmental
and Regulatory mandates for health claims handlers
Ø
The
interplay between Product Development and Underwriting, on the one hand, and,
Claims Management, on the other
Ø
Stakeholders
in the Ecosystem [Provider Network, TPAs]: Aspects of Synergy and Control
Ø
Tools and
Processes to increase efficiency, enhance customer experience and ensure
profitability.
Participants’ Profile: Officials working in
and associated with Health Insurance in various offices in the General Insurance
Industry: Product Designers, Underwriters, Sales Personnel, Operating Unit Heads
apart, of course, from Officials handling the health claims
verticals/departments
Duration: 2 days
Dates: 24.07.2023-25.07.2023