FICCI HEALTH INSURANCE CONFERENCE December 10, 2012 · The Knowledge Paper was developed jointly by...

FICCI HEALTH

INSURANCE CONFERENCE

December 10, 2012 Recommendations

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F I C C I H E A L T H I N S U R A N C E C O N F E R E N C E 2 0 1 2 :

R E C O M M E N D A T I O N S

Acknowledgement

It gives us immense pleasure to come up with the “Recommendations” emerging out of the FICCI

Health Insurance Conference 2012 held on the 10th

of December, 2012 at FICCI Federation House. The

event held on the theme “Getting Behind the Numbers” was a huge success with more than 300

participants from India and abroad contributing to the deliberations.

At the outset, FICCI would like to thank the erstwhile IRDA Chairman, Mr J. Hari Narayan, for having

suggested the theme of Data Analytics for the conference. Through all our endeavours, we have had

his unflinching support and guidance.

We also take this opportunity to thank the members of the FICCI Health Insurance Advisory Group

which has been the guiding light for the conference. We are also indebted to Towers Watson, our

Knowledge Partners for the event. Despite the acute shortage of time, Towers Watson has done

excellent work in bringing out the Knowledge Paper.

We would also like to express our sincere gratitude to all the members of our various sub-groups, who

have worked relentlessly behind the scenes to ensure the success of the conference. We would also

like to acknowledge the thought and knowledge put in by each of the session conveners who put

together the structure for each of their respective sessions.

Above all, we would like to thank all the distinguished speakers and the participating delegates

without whose commitment and involvement in the deliberations the conference wouldn’t have

succeeded.

Organizers

FICCI Health Insurance Conference 2012

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Table of Contents

A. FICCI Health Insurance Conference 2012: Getting Behind The Numbers .......................................... 4

B. Indian Health Insurance Sector .......................................................................................................... 7

C. Recommendations ............................................................................................................................. 9

I. Inaugural Session: .......................................................................................................................... 9

II. Panel Discussion I - Combating Health Insurance Fraud ............................................................. 10

III. Panel Discussion II - Strengthening Quality of Service Delivery .................................................. 12

IV. Parallel Discussion I – Data Analytics in Government Sponsored Health Insurance Schemes ... 14

V. Parallel Session II - Driving Product Design and Customer Segmentation .................................. 16

VI. Panel Discussion III - New Frontiers in Data Analytics: Innovation and Emerging Platform ....... 17

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A. FICCI Health Insurance Conference 2012: Getting Behind The

Numbers

ederation of Indian Chambers of Commerce and Industry (FICCI) organized the FICCI Health

Insurance Conference 2012 on the 10th

of December, 2012 at FICCI, New Delhi. The central

theme of the conference was “Getting Behind the Numbers”.

The conference, now in its 5th

edition, endeavoured to create a suitable platform for the various

stakeholders of the health insurance industry and to deliberate upon relevant issues and solutions

which have a strong bearing not only on the growth of the sector but also help in improving

efficiencies, reducing costs and wastage and improving the delivery of service to the end consumer.

The central theme for the conference this year was “Getting Behind the Numbers”. It is a widely

recognized fact today that the world is witnessing a huge explosion in terms of the data that is being

recorded on a day to day basis. It is estimated that the world is currently creating 2.5 quintillion bytes

of data every day. And surprisingly, research indicates that 90 per cent of all data in the world has

been created in the last two years. This large mass of data is both a challenge and an opportunity for

all stakeholders. Proper cleansing, storage, access and analysis of this data can help us provide many a

useful insight which shall help us create better products, improve efficiencies, reduce wastage, curb

and detect fraud and create a better and improved service delivery mechanism. However, there are

substantial hurdles to this and it is imperative that the stakeholders within the industry come together

to ensure that this huge quantum of data is used in an effective and efficient manner.

The conference witnessed more than 300 participants from India and abroad encompassing Health

Insurance Companies, Government Officials, Healthcare Providers, TPAs, Healthcare Education

Providers, and Financial Institutions.

The inaugural session of the conference was addressed by stalwarts of the Insurance Sector, at the

forefront being the erstwhile Chairman of IRDA; Mr J Harinarayan, who delivered the Inaugural

Address. Besides, the other prominent dignitaries to address the audience were Dr Nandakumar

Jairam, Chairman, FICCI Health Insurance Advisory Group & Chairman and Group Medical Director,

Columbia Asia Hospitals, India, Mr Antony Jacob, Co-Chairman, FICCI Health Insurance Advisory Group

& CEO, Apollo Munich Health Insurance Co. Ltd., Dr Ramesh Govindaraj, Lead Health Specialist, the

World Bank, Mr G Srinivasan, CMD, New India Assurance Co. Ltd and Mr Girish Rao, Co-Chairman,

F

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FICCI Health Insurance Advisory Group and Chairman & Managing Director, Vidal Healthcare Services

Pvt. Ltd. While Dr Jairam made the Welcome Address and Mr Jacob made the Theme Address, Dr

Govindaraj delivered the Keynote Address and Mr Rao made the Concluding Remarks. Mr Srinivasan

delivered a Special Address to the participants.

Inaugural Session L to R: Mr Antony Jacob, Mr G Srinivasan, Mr J Harinarayan, Dr Nandakumar Jairam,

Dr Ramesh Govindaraj, Mr Girish Rao

One of the highlights of the conference was the release of two important papers during the

conference. The Knowledge Paper aptly titled Getting Behind the Numbers: Health Insurance in India

was the first paper to be released and besides providing a brief backdrop to the Health Insurance

Segment in India also talked of how Data Analytics can serve an important role in the health insurance

space. More importantly, it contained several action oriented recommendations that could be

implemented by organizations in the short to medium term without incurring a substantial cost outlay.

The Knowledge Paper was developed jointly by FICCI and Towers Watson.

The other important paper which saw the light of day was the Working Paper on Health Insurance

Fraud developed internally by FICCI. This paper is a typical example of the kind of path breaking work

that FICCI engages in and is committed to. For the first time ever, there was a concerted effort to

define fraud and more particularly distinguish it from Abuse, especially in the Indian context. Despite

the fact that a large body of work already exists in the area of health insurance fraud, it has little

relevance in the Indian context especially because the Indian Penal Code still does not have a

watertight definition for Fraud in the Health Insurance Space. Therefore, this paper is the first step

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towards establishing a stringent framework within which cases of Health Insurance fraud can be dealt

with in a logical and conclusive manner. The working paper, besides identifying fraud, also talks of

ways and means to control, detect and curb fraud from the short term to the long term and its

corresponding impact on cost for the various stakeholders.

Above: IRDA Chairman, Shri J Hari Narayan, releasing the FICCI Towers Watson Knowledge Paper (left)

and the Working paper on Health Insurance Fraud (right)

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B. Indian Health Insurance Sector

early three decades have passed since the first ever structured standalone health insurance

product was introduced in the Indian market. Since then, health insurance business has

come a long way to become one of the fastest growing segments of the Indian insurance

sector. Today, the market is replete with not only numerous health insurance products covering

hospitalization risk in the conventional indemnity based 'mediclaim' mould but also benefit oriented

covers like critical illness and hospital cash. One of the main drivers for this increase in choice for the

consumers has been the opening up of the insurance industry to private sector competition as a part

of the reforms initiated by the Government. Since then, a large number of private sector insurance

companies, mostly joint ventures between Indian companies and reputed global insurance majors

having minority stake, have entered the insurance market in India. As of date, a total of 4 standalone

health insurers and 21 general insurers are licensed to operate in India. Almost all the general

insurance companies also offer health related insurance policies.

The total annual expenditure in the health sector in India is around 5.1% of the GDP, out of this the

public (i.e. Government financed) health expenditure is around 1.2% of GDP. It is estimated that Indian

citizens have to bear almost 61% of their total health expenditure as 'out-of-pocket', on an average

basis. Consequently, nearly 3% of the population gets pushed into below the poverty line every year.

Anecdotal data suggests that in the event of a major illness requiring inpatient treatment, majority of

Indian citizens may end up spending more than 50% of their annual income on health; and nearly 25%

of those hospitalized fall below the poverty line as a result of the financial impact. Much can be

written about the ever increasing cost of medical expenses and hospitalization charges in present day

India. With such skyrocketing medical costs, it is common wisdom that more people will look towards

a health insurance product to secure themselves. However, various incontrovertible data points on the

severity of adverse financial impact of ill health for the economically weaker sections of the society

clearly suggests that it is imperative for health insurance to innovate by focusing on new techniques

around data analytics like predictive modelling etc. to improve the products on offer thereby

increasing the market penetration and product affordability for the customer.

Indian Insurance companies are in some form or the other using “Data analytics”. Most of them are

enabled with powerful IT systems to capture transactional / aggregate level / claims data. The need

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therefore, is to come up with novel methods of using this data to incorporate advanced techniques like

predictive modelling and simpler approaches like customer segmentation before writing a policy. Not

only will data analytics help improve existing business functions but will also help forecast the future

better and write more profitable business.

In summary, health insurance segment in India has grown by leaps and bounds from a single tailor-

made health cover being provided by the PSUs around 30 years back. However, with the number of

competitors in the market increasing, there is need for insurance companies to think out of the box

and make a gradual shift towards more advanced techniques in data analytics that can help take Indian

insurance business further into the future.

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C. Recommendations

I. Inaugural Session:

The key recommendations arising out of this panel discussion are as follows:

� The Indian Penal Code has No clear cut definition of fraud. The whole concept of fraud is often

dealt with under other provisions such as criminal breach of trust and as a result we often do

not have clarity on what constitutes a fraud.

� Further, on many instances there is a situation where even detected fraud is often not pursued

to its logical conclusion.

� Legal action is desirable in order to ensure that adequate sanctions are provided for against

those fraudsters and at the same time there needs to be a preventive aspect to this whole

thing.

� The industry needs to ensure that information is available across the board and make sure that

there is an impetus for collective action going forward.

� One of the first steps towards this could be a simple process like “pay for reporting.”

� This can be further advanced to a model where the industry develops products with wellness

built in to a kind of a managed healthcare so that the whole thing can be managed well in the

interest of all the stakeholders.

� The insurance industry has not focused itself on the medical outcomes. It is time the insurance

industry gets involved in ensuring that the customers who are patients get the best out of the

medical treatment.

� More serious health problems facing the country at large is really the question of nutrition

especially of children, others too like nursing mothers etc.

� It should be possible for us to design a scheme which combines both, the critical care type like

Arogyasri and all kinds of medical hospitalization like the RSBY

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II. Panel Discussion I - Combating Health Insurance Fraud

� The first step towards tackling Fraud is to clearly define Fraud and Abuse – one of the crucial

aspects here is how do we differentiate between the two?

� Once Fraud has been reasonably defined, the next step is Managing Fraud

� There is an urgent need to have the following policies in place pertaining to:

o Anti-fraud Policy

o Investigation policy

o Creation of a Fraud Bureau, as suggested in the Working Paper

� Insofar as Managing fraud is concerned, there is a need for a set of skilled assessors to look

into potential frauds

� Besides, there needs to be a strong regulatory framework which clearly outlines the

requirements for the Investigative agency, the kind of people who conduct the investigation,

their qualifications, experience etc.

� Absence of protocol for the licensing agencies, thus quality of such agencies is highly doubtful

� Appropriate punitive action needs to be defined and taken if fraud is clearly detected

� Further, it is imperative that there is a substantial amount of collaboration, sharing and

collective action by all stakeholders. Simultaneously, it is necessary that the medical fraternity

tries and improves the levels of awareness within.

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� Protocols and procedures are important in terms of diagnosis of diseases and aliments. Need

to have Standardized formats as have already been made by FICCI. Industry needs to be

quicker in adoption of these standardized formats and there is a need to strengthen processes

and controls

� Some basic steps towards mitigating fraud in the short run could be:

o Automated underwriting systems combined with tele-writing

o Front end sales and training for the insurers

o Whistleblower program

� Insurance industry needs to pay attention to the appropriateness of claims. Need to rely on

evidence better clinical knowledge and abilities

� Perhaps there is a need to have outpatient cover as the Indian insurance industry is losing out

by not covering Out patient service since it can also act as a very good gatekeeper

� There is a need to look at the kind of Insurance products that available which do not cover Pre-

Existing diseases which perhaps act as a trigger for fraud

� Need for a public platform through which data can be broadcast however control over the

ownership and authenticity of the data needs to be established

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III. Panel Discussion II - Strengthening Quality of Service Delivery

� There is a need for good patient safety record and a good clinical outcome at the optimal cost

� There needs to be a certain basic quality which is implicit in the relationship that if an insured

buys from a branded insurance company then he will be assured of a certain basic quality if

this provider is a part of their network which necessarily implies that payors start demanding

quality

� Further, it is important that just like the hospitals need to share the data, the insurance

companies too need to share the data which shall help the consumer make a more informed

choice.

� Further, if there was more information like above then insurers and hospitals will have access

to more data and shall have more trust in their relationship since then we will see faster and

more clear approvals coming out of the insurance company which will eventually benefit the

hospital which eventually benefits the consumer.

� There is a pressing need for standardization. Standardization relates to empanelment criteria,

drawing up MOUs across hospitals etc. There are no standards. Thus there is a need for the

industry as a whole to move towards Standardization.

� There needs to be some innovation in the design of Health Insurance Products, for example:

there could be products which allow people going by the grades of a hospital. Consumers go to

a hospital which is a minimum grade hospital and pay premiums accordingly; however, if they

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go to a higher/better hospital, they may have to bear a part of the cost as a co-payment. Such

types of products have to come in.

� For grading hospitals, there has to be an effort to have more reliance on quality indicators like

the death rate, mortality rate, etc. But for the industry to be able to differentiate, more data

on output, on patient safety, on clinical outcomes is required to be made available. At the

same time, this information needs to be made available to the consumer so that he can make

an informed choice.

� There needs to be a greater dialogue between the Quality Council of India through its

representatives that is National Board of Quality Promotion (NBQP) and the NABH and the

insurance industry.

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IV. Parallel Discussion I – Data Analytics in Government Sponsored Health

Insurance Schemes

� Government-sponsored health insurance schemes face severe constraints in adequacy of

institutional architecture and their management capacity for their major functions. These

schemes work with severe human resource constraints in terms of numbers as also with

limited capacity building opportunities.

� Creating red flags, creating triggers, creating alerts, creating outlier reports will be some of the

ways in which the managerial ability to run these schemes despite limited manpower is

certainly strengthened.

� In terms of Strategic Purchasing the monitoring of providers or being able to work with

providers on improving the delivery platforms, this whole thing is sporadic and usually

responds to a grievance or a claim-related issue. The current MOUs structure is not very

adequate or even influencing provider behaviors, in part because there is very little

enforcement or monitoring possible with the sketchy manpower that most of the schemes

have. In such an environment, good data analytics can enable analysis of provider

performance, identify outliers who are doing something which is not normal, abnormal,

monitor deviations from expectations, create automatic ‘red flags’, provide information and

opportunity to drive reform/redesign and improvements in service delivery. There is a huge

potential that lies there and data analytics will be the important tool to achieve that.

� Data analytics can make possible control systems along three domains:

o Constant vigil on claims data; you keep seeing what is happening with the claim as it

happens.

o Automated as well as re reviews of pre-authorization requests. Lot of what is

happening in pre-authorization can actually be automated and it will only trigger some

red flags or alerts when required and even re-review.

o Finally, because the data is provided in real time and the patient is still in the hospital,

if we can identify through good quality business intelligence, what seems to be

suspicious, we can do physical verification of beneficiaries and what treatment they

are being given in time to be able to detect some of this mis-utilisation and fraud.

� Areas like enrollment, provider selection and access, access, benefit coverage, treatment

choices, quality of care, access to follow-up care, dealing with illegitimate provider charges,

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and this whole navigation of grievance and complaint processes are areas where we need to

inform the consumer better and to be able to inform the consumer better, we need to mine

our own data.

� Perhaps there is a need to grade the hospitals and categorize their services not only based on

the infrastructure but also based on the quality. Every pre-authorization sent by the hospitals

will have a scoreboard of that hospital. That score board indicates how many pre-authorization

has been given in concise fashion. A doctor can click into that and see how many of those

particular surgeries have been performed, whether this hospital has got adequate

infrastructure in terms of their ability to perform.

� In the absence of standard methodology, though there are guidelines, there are certain areas

where we don’t have Indian guidelines, and in the context of that, it is very difficult to monitor

the quality or the standards of the treatment.

� We do not have any strong confidentiality laws. So when we have to talk about laws, we take

refuge to the Information Technology Act 2000 at times in the absence of any other

confidentiality law. This is an area where we have to innovate even otherwise.

� In terms of strategies for fraud mitigation, strategies for detection of anomalies, and triggers

which are being used, there is a lot of scope for schemes to learn from each other because all

the schemes are talking huge numbers, 6 crores, 7 crores, 10 crores people; it is a huge

number we are talking and that is where the synergies can be developed.

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V. Parallel Session II - Driving Product Design and Customer

Segmentation

� As we stand today in terms of the work that has been done in the non life industry, the level of

sophistication that there is around customer segmentation and product development, is still

fairly nascent and there is much that remains to be done.

� If we have to increase the penetration, we need to develop product offerings that are more

fine tuned to what the customer needs & wants. One big challenge the industry will have to

really overcome is getting the data to price these products

� There is a tendency to actually equate the product segmentation by incomes with actual

policy’s size

� As the industry gets more sophisticated, segmentation could be done on the basis of customer

behavior.

� The industry needs to come up with ways to leverage resources like the Credit Bureaus, some

have the advantage of the group companies, so how does one leverage the group companies

to supplement customer data inside and actually be more relevant to the customer when one

gives the offering to the customer.

� Started looking at some sort of pricing inflation tools which allows us to get a hang of inflation

not only from our perspective but also from the consumer perspective

� Another aspect that the industry needs to look into is how does the health insurance company

actually try and improve the health of the population in insurance and how to get that

integration between better lifestyle and therefore, lower premium.

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VI. Panel Discussion III - New Frontiers in Data Analytics: Innovation and

Emerging Platform

There should be a National Grid which can link up insurance and non insurance data in a sequential

and tagged way.

Quality can be improved by:

� Everyone needs to agree upon standards of proper quality care and there is a need for peer

pressure as no one wants to be low on compliance when this data is in the public domain.

� Data is available but what we need is a single grid through which we get this data at the point

of underwriting or at the point of claims management

� Government needs to think of a Regulatory body for healthcare providers

� Need to work on the unorganized health insurance markets

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About FICCI

Federation of Indian Chambers of Commerce and Industry (FICCI)

Established in 1927, FICCI is the largest and oldest apex business organization in India. Its history is

closely interwoven with India's struggle for independence and its subsequent emergence as one of the

most rapidly growing economies globally. FICCI plays a leading role in policy debates that are at the

forefront of social, economic and political change. Through its 400 professionals, FICCI is active in 38

sectors of the economy. FICCI's stand on policy issues is sought out by think tanks, governments and

academia. Its publications are widely read for their in-depth research and policy prescriptions. FICCI

has joint business councils with 79 countries around the world.

A non-government, not-for-profit organization, FICCI is the voice of India's business and industry. FICCI

has direct membership from the private as well as public sectors, including SMEs and MNCs, and an

indirect membership of over 83,000 companies from regional chambers of commerce.

FICCI works closely with the government on policy issues, enhancing efficiency, competitiveness and

expanding business opportunities for industry through a range of specialized services and global

linkages. It also provides a platform for sector specific consensus building and networking.

Partnerships with countries across the world carry forward our initiatives in inclusive development,

which encompass health, education, livelihood, governance, skill development, etc. FICCI serves as the

first port of call for Indian industry and the international business community.

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FICCI HEALTH INSURANCE TEAM

Mrs Shobha Mishra Ghosh

Senior Director

Sidharth Sonawat

Senior Assistant Director

Sudhiranjan Banerjee

Assistant Director

FICCI Health Insurance Division

FICCI, Federation House

Tansen Marg, New Delhi – 110 001

Tel: 011 23487246 (D), 011 2373 8760 - 70 (Ext. 513/ 438/ 220)

Fax: 011 2332 0714, 011 2372 1504

Email: [email protected]

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SPEAKER SESSION WISE

Name Designation Organization

INAUGURAL SESSION

Dr Nandkumar Jairam Chairman & Chairman and Group

medical Director

FICCI Health Insurance Advisory

Group, Columbia Asia Hospitals

Dr Ramesh Govindaraj Lead Health Specialist World Bank

Mr. G Srinivasan CMD New India Assurance

Mr. J Harinarayan Chairman IRDA

Mr. Antony Jacob Chairman, CEO FICCI Advisory Group on Health

Insurance & Apollo Munich Health

Insurance Co

Mr. Girish Rao Co-Chairman & Chairman &

Managing Director


Board & Vidal Healthcare Services

Pvt Ltd

PANEL DISCUSSION I - Combating Health Insurance Fraud

Chair

Mr. Mukesh Chawla Head of Knowledge Management,

Human Development Network

World Bank

Presentation


Managing Director


Board & Vidal Healthcare Services

Pvt Ltd

Panellists

Dr. C H Asrani Chief Executive X-Claim

Ms Malti Jaswal Consultant – Project TPA GIPSA

Mr. Nazeem Khan VP ICICI Lombard

Mr. Jagbir Sodhi Director - Life & Health SwissRe

PANEL DISCUSSION II - Strengthening Quality of Service Delivery

Chair

Mr R Chandrasekaran Secretary General General Insurance Council

Presentation

Mr. Anuj Gulati CEO & MD Religare

Panellists

Dr. Narottam Puri Advisor & Chairman FICCI Health Services & NABH

Mr. Manohar Kumar Head - Group Insurance Avantha Holdings Ltd

Mr Shreeraj Deshpande Head – Health Insurance Future Generali India Insurance

Company Ltd

Dr. Praneet Kumar Chairman & CEO Technical Committee, NABH & BLK

Super Specialty Hospital

PARALLEL SESSION I - Data Analytics in Govt. Sponsored Health Insurance Schemes

Chair

Ms April Harding Lead Public Private Partnership

Specialist

The World Bank

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Presentations

Dr. Somil Nagpal Senior Health Specialist World Bank

Dr. Nishant Jain Deputy Programme Director GIZ

Panellists

Dr. S Prakash Director - Medical Management Suvarna Arogya Suraksha Trust

Mr. Pankaj Kumar Bansal Project Director Tamil Nadu Health Systems Project

(TNHSP)

Dr. Satish Raghavan Deputy Director Tamil Nadu Health Systems Project

(TNHSP), Government of Tamil Nadu

PARALLEL SESSION II - Driving Product Design and Customer Segmentation

Chair

Presentation

Mr. Krishnan Ramachandran COO Apollo Munich Health Insurance

Panellists

Mr Manasije Mishra CEO Designate Max Bupa Health Insurance

Mr Binay Agarwala SVP & Head ICICI Pru Life

Mr. Sanjay Datta Head- Underwriting and Claims ICICI Lombard General Insurance Co

Ltd

Ms Tajinder Mukherjee DGM New India

PANEL DISCUSSION III - New Frontiers in Data Analytics: Innovation and Emerging platform

Chair

Mr. R Raghavan CEO Insurance Information Bureau

Presentation & Convener

Mr Alam Singh Assistant MD Milliman

Panellists

Mr Shivakumar Shankar Managing Director LexisNexis Risk Solutions India

Mr. Manish Desai Associate Director - Information

Management & Customer

Advocacy, South East Asia

SAS

Mr. Kent Sacia Milliman

Mr Punit Santani Practice Head, Information

Management

SAS

Mr Gautam Mazumdar Senior Consultant – General

Insurance

Towers Watson

CONCLUDING SESSION

Summary of Proceedings


Valedictory

Mr. Mukesh Chawla Head of Knowledge Management,

Human Development Network

World Bank

Concluding Remarks & Vote of Thanks

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DELEGATE LIST

Name Designation Organization

Dr. Ramesh Govindaraj Lead Health Specialist World Bank

Mr. G Srinivasan CMD New India Assurance

Mr. J Harinarayan Chairman IRDA

Mr. Antony Jacob Chairman, CEO FICCI Advisory Group On Health Insurance

& Apollo Munich Health Insurance Co


Managing Director

FICCI Health Insurance Advisory Board &

Vidal Healthcare Services Pvt Ltd

Mr. Mukesh Chawla Head Of Knowledge

Management, Human

Development Network

World Bank

Dr. C H Asrani Chief Executive X-Claim

Ms. Malti Jaswal Consultant – Project TPA GIPSA

Mr. Nazeem Khan VP ICICI Lombard

Mr. Jagbir Sodhi Director - Life & Health Swissre

Mr. R Chandr.Asekaran Secretary General General Insurance Council

Mr. Anuj Gulati CEO & MD Religare

Dr. Narottam Puri Advisor & Chairman FICCI Health Services & NABH

Mr. Manohar Kumar Head - Group Insurance Avantha Holdings Ltd

Mr. Shreeraj Deshpande Head – Health Insurance Future Generali India Insurance Company

Ltd

Dr. Praneet Kumar Chairman & CEO Technical Committee, NABH & BLK Super

Specialty Hospital

Mr. RK Jain Additional Secretary & DG

(CGHS)

Mohfw, Goi


Dr. Nishant Jain Deputy Programme Director GIZ

Dr. S Prakash Director - Medical Management Suvarna Arogya Suraksha Trust

Mr. Pankaj Kumar Bansal Project Director Tamil Nadu Health Systems Project

(TNHSP)

Dr. Satish Raghavan Deputy Director Tamil Nadu Health Systems Project

(TNHSP), Government Of Tamil Nadu

Mr. NSR Chandr.Aprasad CMD National Insurance Co Ltd

Mr. Krishnan

Ramachandr.An

COO Apollo Munich Health Insurance

Mr. Manasije Mishra CEO Designate Max Bupa Health Insurance

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Mr. Binay Agarwala SVP & Head ICICI Pru Life

Mr. Sanjay Datta Head- Underwriting And Claims ICICI Lombard General Insurance Co Ltd

Mr. R Raghavan CEO Insurance Information Bureau

Mr. Alam Singh Assistant MD Milliman

Mr. Shivakumar Shankar Managing Director Lexisnexis Risk Solutions India

Mr. Manish Desai Associate Director - Information

Management & Customer

Advocacy, South East Asia

SAS

Mr. Kent Sacia Milliman

Mr. Gautam Mazumdar Senior Consultant – General

Insurance

Towers Watson

Dr. Bhabatosh Mishra Senior Vice President -

Underwriting & PD

Apollo Munich Health Insurance Co Ltd

Mr. Rajeev Nandan Head & Insurance Govt Affairs Alcon India

Mr. Shamik Banerjee Vice President - D2C &

Marketing

Apollo Munich Health Insurance Co Ltd

Dr. Devlina Chakravarty Chief Operating Officer &

Director- Medical Services

Artemis Healthsciences

Mr. Vibhav Garg Head-Health Economics & Govt

Affairs

Boston Scientific India Pvt. Ltd.

Ms. Lalita H Dewlekar IPD- Incharge BSES MG Hospital

Ms. Priyanka Ghosh Assistant Manager- Marketing &

Sales North

DOC N DOC

Dr. Mahendr.A Doshi Director-Health Tourism DOC N DOC

Ms. Aashruti Kak Sr. Sub Editor DOC N DOC

Dr. Rolf Schmachtenberg (Programm Director) GIZ

Mr. Manu Sehgal Business Development Leader Equifax

Dr. Madan Gopal (Sr. Technical Expert) GIZ

Mr. Puneet Kanodia Manager- Business Advisory

Services

Ernst & Young Pvt Ltd.

Ms. Anju Aggarwal

(RSBY Consultant) GIZ

Mr. Vikas Kuthiala MD Falck India

Dr. Amit Bhanot Futures Group

Ms. Urvashi Chandr.A (Technical Advisory Evaluation) GIZ

Mr. Neelesh Garg ICICI Lombard General Insurance Co

Limited

Mr. ABHIK JHA ACTUARIAL ANALYST HANNOVER RE

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Mr. Ashokkumar

Sarojananjundan

DIRECTOR- HANNOVER RE HANNOVER RE

S Dinesh Kumar Assistant Manager - Actuarial HDFC ERGO General Insurance Company

Ltd

Deepak Vatsa Senior Manager HDFC ERGO General Insurance Company

Ltd

Mr. Divyanshu Bhardwaj Student I N L E A D

Ms. Shalini Chandr.A Student I N L E A D

Ms. Shailja Student I N L E A D

Ms. Charu Chaurasia Student I N L E A D

Ms. Merina

Sorenshangbam Student I N L E A D

Ms. Navleen Kaur Student I N L E A D

Ms. Kirti Golatkar Student I N L E A D

Mr. Ravi Pratap Singh Student I N L E A D

Ms. Sakshi Kaushik Student I N L E A D

Ms. Pratibha Rathore Student I N L E A D

Mr. Kunwar Singh Student I N L E A D

Ms. Lavika Sharma Student I N L E A D

Mr. Bhupesh Tiwari Modern Medicare

Mr. Dhruv Kumar Senior Manager - Insurance Policy Bazar (Apollo Munich Health

Insurance Co Ltd )

Ms. Shivani Rawat Student I N L E A D

Mr. Abhishek Rana Student I N L E A D

Mr. Qadir Ali Student I N L E A D

Mr. Dheeraj Nag Student I N L E A D

Mr. Harish Basavaraj Chief Manager - Underwriting ICICI Prudential Life Insurance Company

Ltd

Mr. Sarang Gokhale Vice President Underwriting ICICI Prudential Life Insurance Company

Ltd

Mr. Sanjay Seth Executive Vice President IFFCO Tokio General Insurance Co. Ltd

Dr. Kirti Udaiyai IIHMR

Mr. Akhil Sharma India Life Capital Pvt. Ltd.

Dr. Jitendr.A Nagpal Health Insurance Consultant Indraprastha Apollo Hospitals

Mr. Ramakrishna Pappu Analyst Innaccel

Dr. Rajesh Bhalla Dean-Academics & Student Affairs International Institute Of Health Management

Research

Ms. Shivani Kohli Manager JK Risk Managers & Insurance Brokers Ltd.

Ms. Shilpa Saxena Manager JK Risk Managers & Insurance Brokers Ltd.

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Mr. Srivatsan CEO Vidal Healthcare Pvt Ltd

Ms. Meenakshi Sharma Deputy Manager JK Risk Managers & Insurance Brokers Ltd.

Mr. Adarsh Shrivastava Assistant Manager JK Risk Managers & Insurance Brokers Ltd.

Mr. Bhupan Singh Deputy Manager JK Risk Managers & Insurance Brokers Ltd.

Mr. Sarabjot Singh Vice President Marsh India Insurace Brokers Pvt LTD

Mr. Vidyesh Khanolkar Head- Insurance,Asia Pacific,

India & Middle East

Mastek Ltd

Dr. Kailash Shelke Head - Medical Underwriting Max Bupa Health Insurance

Dr. Vikram Roy Head – Claims Max Bupa Health Insurance

Mr. Mohd Ali Zaidi Chief Manager -Provider

Contacts

Max Bupa Health Insurance Co. Ltd.

Mr. Jatin Varshney Vice President Underwriting Max New York Life Insurance Co. Ltd.

Ms. Elly Zervoudakis MCN Consulting

Ms. Rajni Mehta Zonal Head Medi Assist India TPA Pvt. Ltp.

Ms. Jayata Sharma Media

Mr. Adish Labru Director Medsave Healthcare (TPA) Ltd.

Mr. Arvind K Saraf Chairman Medsave Healthcare (TPA) Ltd.

Mr. Simon Herborn Consultant Actuary Milliman India Private Limited

Ms. Kshama Saluja Actuarial Trainee Milliman India Private Limited

Ms. Mr.Unal Pandit Sr Consultant Ministry Of Health And Family Welfare

Ms. Deepti Mohan Astt. Director National Accreditation Board For Hospitals

& Healthcare Providers

Ms. Kalpana Singh Deputy General Manager NATIONAL INSURANCE

Mr. ALN Prasad General Mgr - Marketing &

Business Development- Lab

Diagnostics

Piramal Healthcare

Mr. Mushahid Ali Khan Senior Consultant Pricewaterhousecoopers Private Limited

Mr. Mayank Makkar Associate Pricewaterhousecoopers Private Limited

Mr. Vijay S Taragi Manager-Marketing Santokba Durlabhji Memorial Hospital

Dr. ASHOK Agarwal Sarvodaya Hospital

Mr. Ashish Aggarwal Finance Controller Sarvodaya Hospital

Mr. Rajnish Kohli Asst. Vice President Star Health And Allied Insurance Co.

26 | P a g e



Ms. Mita Bhattacharjee DGM THE NEW INDIA ASSURANCE CO LTD.

Mr. JP Sheokhand DGM THE NEW INDIA ASSURANCE CO LTD.,

Dr. Balla Swamy Chief Manager THE NEW INDIA ASSURANCE CO LTD.,

Ms. Poonam Trivedi Manager The Oriental Insurance Co.Ltd.

Mr. Gaurav Admn.Officer The Oriental Insurance Co.Ltd.

Mr. Vikram Rajan Sr Health Specialist World Bank India

Mr. Mahesh C Verma

Dr. Aarti Sheetal Student I N L E A D

Dr. Syed Ali Student I N L E A D

Dr. Bhavesh Imr.An Malvia Student I N L E A D

Dr. Mustafa Khan Student I N L E A D

Dr. Prashant Mahangade Student I N L E A D

Dr. Swapnil D Kakad Student I N L E A D

Dr. Sachin Singh Student I N L E A D

Dr. Monika Sharma Student I N L E A D

Dr. Lipika Student I N L E A D

Dr. Yagnik Chudasama Student I N L E A D

Dr. Eesha Arora I N L E A D

Ms. Ginny Kaushal I N L E A D

Dr. Rujuta Sanap Student IIHMR, Jaipur

Dr. Vijay Desai Student IIHMR, Jaipur

Dr. Harish Gawande Student IIHMR, Jaipur

Dr. Keshav Bharadwaj Student IIHMR, Jaipur

Dr. Gaurav Mishra Student IIHMR, Jaipur

Dr. Ashish Kumar Tiwari Student IIHMR, Jaipur

Dr. Ankuri Setia Student IIHMR, Jaipur

Dr. Chetan VT Student IIHMR, Jaipur

Dr. Mudita Puri Student IIHMR, Jaipur

Dr. Niteengujarati Student IIHMR, Jaipur

Dr. Vikash Sharma Student IIHMR, Jaipur

Dr. Varun Joshi Student IIHMR, Jaipur

Dr. Samr.Iddhi Jain Student IIHMR, Jaipur

Dr. Nipun Kanwar Student IIHMR, Jaipur

Dr. Shiny Varghese Student IIHMR, Jaipur

Dr. Bhavna Nahata Student IIHMR, Jaipur

Dr. Nidhi Gupta Student IIHMR, Jaipur

Dr. Navdeep Kaur Student IIHMR, Jaipur

Dr. Gargi Mehra Student IIHMR, Jaipur

27 | P a g e



Dr. Rohan Gheewala Student IIHMR, Jaipur

Dr. Faheem Fatima Student IIHMR, Jaipur

Dr. Kajal Chauhan Student IIHMR, Jaipur

Mr. Ravi Kumar TTK Health TPA Private Limited

Mr. Minati Gadr.E TTK Health TPA Private Limited

Mr. Shandeep TTK Health TPA Private Limited

Mr. Ashish Saxena GM Operations Mumbai TTK Health TPA Private Limited

Mr.S Sheela Anand COO Operations TTK Healthcare TPA Private Limited

Mr. Sudhir Patro AVP Business Development TTK Healthcare TPA Private Limited

Mr. Ravi Modali AVP Medical Services TTK Healthcare TPA Private Limited

Neetha AGM Operations Bangalore TTK Healthcare TPA Private Limited

Naveen Narang AGM Operations TTK Healthcare TPA Private Limited

Mr. Satish Raju CEO TTK Healthcare TPA Private Limited

Mr. Amalendu Pal Managing Director ACPDA - Ig3 Solutions

Ms. Komal Kakkar Assistant Manager - Corporate

Communications

Apollo Munich Health Insurance Co. Ltd.

Mr. Jimmy John Representative For South Asia Asia Insurance Review

Mr. Paul Rader Senior Vice President Atlas Research

Ms. Mythili Bhusnurmath Consulting Editor : Level Of

Senior Editor

Bennett, Coleman & Co. Ltd.

Mr. P S Nagpal Professor Birla Institute Of Management Technology

Mr. Rajiv Kapahi Director Finace India Hub Boston Scientific India Pvt. Ltd.

Ms. Sarita Rawat Head-Cooperate Accounts Boston Scientific India Pvt. Ltd.

Dr. Kishore Murthy Director-Healthcare Research Brickwork Ratings

Mr. Naresh Kumar Sagar Chairman Enkay Sagar Holdings Pvt. Ltd.

Mr. Vineet Bansal Director-Business Development Falck India Pvt. Ltd.

Mr. G Bharathi Vice President & CAO Family Health Plan TPA Ltd.

Ms. Shruti Goel Associate, Business

Development

Futures Group

Ms. Shuvi Sharma Deputy Country Director Futures Group

Ms. Kalpana Singh Deputy General Manager General Insurers' (Public Sector)

Association Of India (Project TPA)

Mr. GLN Sarma Managing Director Hannover Re Consulting Services India Pvt.

Ltd.

28 | P a g e



Dr. Kashyap Dakshini Vice President-Claims HDFC Ergo General Insurance Co. Ltd.

Mr. Antonio Ferreiro Appointed Actuary HDFC Ergo General Insurance Co. Ltd.

Mr. Nikunj Gheewala Assistant Vice President-

Underwriting

HDFC Ergo General Insurance Co. Ltd.

Mr. Sujit Sinha Vice President-Strategic

Planning Group

HDFC Ergo General Insurance Co. Ltd.

Ms. Aruna Mehta Certified Financial Consultant HDFC Standard Life Insurance Co. Ltd.

Mr. Nitin Sharma Country Services Principal, FSI Hewlett_Packard India Sales Pvt. Ltd.

Gp Capt (Dr.) Sanjeev Sood NABH Empanelled Assessor Hospital & Health Systems Administrator

Mr. (CA) A K Aggarwal Executive Director HSCC India Ltd.

Dr. Sanjay Tiwari Associate Vice President -

Investigation

ICICI Lombard General Insurance Co. Ltd.

Dr. Porus Peshoton Associate Vice President-Health

Claims

ICICI Prudential Life Insurance Company

Limited

Dr. Priya Parmar Director-Operations Indian Cancer Society

Mr. Saurabh Sharma Founder & CEO Indus Insights Pvt. Ltd.

Mr. Ramakrishna Pappu Analyst Innaccel

Mr. SK Sethi Vice President Insurance Foundation Of India

Mr. Rakesh Bajaj Joint Director Insurance Regulatory And Development

Authority

Mr. Manish Jain Director - Health Policy Jhonson & Jhonson

Mr. Orindam Sen Chief Assistant JK Risk Managers & Insurance Brokers Ltd.

Mr. Satvinder Singh Head-Finance & Admin. JK Risk Managers & Insurance Brokers Ltd.

Mr. Vinod Kureel Regional Manager (Health

Insurance)

LIC Of India

Mr. Vipul Sud Regional Manager-India Mastek Limited

Mr. Nikhil Apte Sr. Vice President & Head -

Products


Mr. Gagan Bhalla Director - Strategy & Operations Max Bupa Health Insurance Co. Ltd.

Mr. Biresh Giri Appointed Actuary Max Bupa Health Insurance Co. Ltd.

Mr. Gaurav Sharma Chief Manager - Products Max Bupa Health Insurance Co. Ltd.

Dr. Kailash Shelke Associate Vice President & Head

Underwriting


29 | P a g e



Ms. Priti Singh Director - Customer Services Max Bupa Health Insurance Co. Ltd.

Dr. Rajeev Virmani Head - Relationship Doctors Max Bupa Health Insurance Co. Ltd.

Ms. Archana Pandey Director - External Affairs Max India Ltd.

Ms. Rajni Mehta Vice-President Medi Assist India TPA Pvt. Ltd.

Ms. Priyanka Ghosh Assistant Manager - Sales &

Marketing

Media Transasia India Ltd.

Mr. Tarun Ratta Chief Information Officer Medsave Healthcare (TPA) Ltd.

Ms. Anchal Anand Acturial Consultant Mercer Consulting India Private Ltd.

Mr. Richard A Kipp Managing Director Milliman

Mr. Lalit Baveja Sr. Healthcare Consultant Milliman India Pvt. Ltd.

Mr. Ravikumar Shekhar Employee Benefits Consultants Milliman India Pvt. Ltd.

Mr. Kishore Dudani, IFS

Retd

Ministry Of External Affairs

Dr. Sidharth Kachroo Head Of Health Business

Development

Munich Re India Services

Mr. Nikunj Sharma Senior Correspondent Network18 Media & Investments Ltd.

Mr. Samiran Lahiri President,Financial Products

Distribution

Peerless Developers Ltd.

Mr. Harmanjeet Singh

Baweja

Deputy Manager-Supply Chain Philips Electronics India Ltd.

Mr. Dhruv Sarin Business Unit Head - Health Policy Bazar.Com

Ms. Manisha Chettri PR Pundit

Dr. BK Rana Joint Director Quality Council Of India

Dr. PM Bhujang Medical Director Reliance Industries Ltd.

Mr. Ketan Ravesia Vice President - Finance &

Accounts

Reliance Infosolutions Pvt. Ltd.

Mr. Arjun Chawla Manager - Brand & Corporate

Communication

Religare Health Insurance Co. Ltd.

Mr. Ashish Kumar Jha Sales Manager Religare Health Insurance Co. Ltd.

Mr. Vishal Sharma Sales Manager Religare Health Insurance Co. Ltd.

Mr. Anil Shimpi Business Head-(Commercial)

NCR & UP

Royal Sundaram Alliance Insurance

Company Limited

Mr. Hernan L Fuenzalida-

Puelma, Esq, LLM

Senior Health Policy Adviser Sanigest Internacional

Mr. James A Cercone President Sanigest Solutions

Dr. Gopal Sharma Consultant-Children & New Born

Diseases

Satya Bhama Hospital Pvt. Ltd.

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Mr. Dinanath Nagpure Head-Claims SBI Life Insurance Co. Ltd.

Mr. Abhishek Bhartia Director Sitaram Bhartia Institute Of Science &

Research

Mr. Amr.Ish Sehgal Director Skyline Business School

Mr. Deepesh Goorha Business Head SPA Insurance Broking Services Ltd.

Mr. Arif Fahim Associate Manager-Strategic

Planning, Therapy Planning

St Jude Medical India Pvt. Ltd.

Mr. Rajnish Kohli Asst. Vice President-Claims Star Health & Allied Insurance Co. Ltd.

Mr. Narinder Kumar Deputy General Manager The New India Assurance Co. Ltd.

Ms. Tajinder Mukherjee Deputy General Manager The New India Assurance Co. Ltd.

Mr. LD Pahwa Insurance Consultant The New India Assurance Co. Ltd.

Mr. Raunak Jha Senior Consultant Towers Watson

Mr. Goutham Kondapalli Senior Consultant Towers Watson

Mr. Vikas Newatia Director & Practice Leader -

General Insurance, India

Towers Watson

Dr. Ravikumar Modali AVP - Medical Services TTK Healthcare TPA Pvt. Ltd.

Mr. M Venkatesh Assistant General Manager TTK Healthcare TPA Pvt. Ltd.

Ms. Shivli Katyayan Associate Tuli & Co.(Solicitors & Advocates)

Mr. Ankit Thakur Associate Tuli & Co.(Solicitors & Advocates)

Dr. Rajesh Shukla Line Head - Claims (A&H And

Travel)

Universal Sompo General Insurance Co.

Ltd.

Dr. Amitoj Singh Head - Health Universal Sompo General Insurance Co.

Ltd.

Mr. Ashok Jha Project Management Specialist

(Health Finance)

USAID

Dr. Sarvjit Dudeja Consultant & Advisor On Science

& Technology

FICCI HEALTH INSURANCE CONFERENCE December 10, 2012 · The Knowledge Paper was developed jointly by...

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