consumer complaints

Part 5 of 5: Complaints Handling by Ombudsman

Ms. Sudha Ramanujam, Deputy Secretary, Office of the Insurance Ombudsman, Chennai spoke next, sharing valuable tips on how to improve relations between the insured and the insurer and how to make the claims-handling process better. She clarified the role of the Insurance Ombudsman in this regard. She said many in the public thought it was just another insurance company.

Part 4 of 5: Hospital Perception to Insurance

Dr. Arjun Rajagopalan commented that the hospital provider is an important stakeholder in this process and introduced Mr. Sameer Mehta, CEO of Mehta Hospitals to speak on “Hospitals perception to insurance – cash or cashless”. He introduced Mr. Mehta as a multi-faceted personality who would discuss the perspective of the healthcare provider and the consumers.

Part 3 of 5: Evaluation of Claim Reimbursements

Next, Ms. Usha V. Girish, Chief Manager, Health Department, United India Insurance Company, spoke on “Evaluation of claim reimbursements”. She began by assuring the audience that even though she represented an insurance company, she understood the consumers' point of view well. Moreover, her company was a public sector undertaking and therefore not as profit-oriented as other private sector insurance firms.

Part 2 of 5: Understanding a Policy Document

The second section of the seminar began with Dr. Arjun Rajagopalan explaining what an insurance policy document is and what it covers. He introduced Dr. Jai Kishen Avula - a medical practitioner and an expert on health insurance who explained in detail the process of understanding an insurance policy document. He reiterated that health insurance is gaining more importance and that 60% of in-patients admitted into hospitals have medical insurance.

CAG, Chennai organized a consumer guidance seminar on October 05, 2016, to discuss the complexities in the medical insurance industry and to increase consumers’ awareness about the intricacies specific to this field . This is the first of a series of five blogs discussing the day’s events and addressing issues raised over the course of the programme. The five blogs are listed together below for viewers’ convenience.