P625 - PROFITABLE
MANAGEMENT OF HEALTH PORTFOLIO (NON-LIFE)
Background
The share of Health Insurance in the total general
insurance business has increased from 24.11% in FY 2014-15 to 29.35% in FY
2020-21. The portfolio has registered a CAGR of 20% over the last decade. With
the introduction of PMJAY, the Health Insurance segment is expected to grow at a
higher rate in the future. The other factors which have fuelled the growth
include pandemic, new medical procedures, entry of more standalone health
insurers, product innovation , an increasing focus on OPD, wellness,
introduction of new distribution channels and increasing role of technology in
customer service.
Though the Health Insurance business is a large
portfolio it is also one of the largest contributor to underwriting losses.
The issues and challenges that the Health Insurance is facing must be
holistically addressed to make it a sustainable portfolio. Handling of the
subject requires knowledge and skills in various fields including developments
in the health care industry, market dynamics, products, Government schemes,
innovation, distribution, regulations, medical underwriting, TPA management, PPN
management, claims management
Objectives
This
programme aims to equip participants with knowledge and understanding of
Ø
Portfolio trends and its implication
Ø
Regulations and its implications
Ø
Health Innovation in
Ø
Framework of medical underwriting
Ø
Effective Claims management
Contents
Ø
Health Care
Scenario in India
Ø
Introduction to Health Insurance:
Business and Trends
Ø
Health Insurance Regulations
Ø
Framework Medical Underwriting
Ø
Health Insurance products
Ø
OPD, Wellness
Ø
Handling Corporate Health Accounts
Ø
Ayushman Bharat: PMJAY and its
management
Ø
Provider Management
Ø
Claims Management
Ø
Fraud Management
Ø
Management of TPAs
Ø
Enhancement of Engagement with Health
Insurance Customers
Ø
Profitability in Health Insurance
Duration: 3 days
Dates: 09.11.2022 - 11.11.2022