The IndiMR Vision
  • A Proposal to Revolutionize India’s Healthcare
  • What Do We Propose?
  • Problems
    • Lack of Medical Facilities and Expertise
    • Lack and Unavailability of Medical Records
    • Lack of Data Standards and Interoperability
    • Increased Costs to People and Organizations
    • Lack of Reliable Data for Policy and Medical Research
    • Poor Spread of Health Insurance
    • Pilferage, Corruption, Fraud and Inefficiencies
  • General Contours of the Proposed Project
    • Why Open Source?
  • India’s Unique Position, Why India? Why Now?
  • Requirements and Unique Challenges
    • mHealth Centric
    • Blockchain Based
    • Knowledge-Based System – Separation of Knowledge from Software
    • Flexible and Composable
    • Collaboration and Workflow Orientation
    • Role of Artificial Intelligence
    • Integration of Miscellaneous Healthcare Associated Processes
    • Force Multiplier Effect – Orchestra Model
  • Benefits for India
    • Improved Healthcare for Indians
    • Public Health Impact
    • Health and Healthcare Policy Research
    • Spurt in Technology Innovation
    • Boon for Private Sector
    • Boost to Insurance Sector
    • Standards-Based Approach
    • Job Creation in Healthcare
    • Centralized Functions with Economies of Scale
    • Increased Soft Clout for India
  • Funding for Pilot Project and the Prototype System
  • Counter Arguments
    • "Indian Healthcare has so many basic problems, why not solve them first?"
    • "But This Has Already Been Done!"
  • Conclusions
  • Authors
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  1. Benefits for India

Boost to Insurance Sector

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Last updated 6 years ago

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As mentioned , availability of large volumes of data from the National EMR system should encourage the insurance companies to provide policies that meet the needs of a diverse set of clients without blindly risking their investments. This could prove to be the boost that the moribund private insurance sector needs, to achieve the levels of insurance coverage in other emerging countries.

Government’s role in insurance is going to take a big leap with the launch of the National Health Protection Scheme (NHPS). This will subsume the previously existing program called Rashtriya Swasthya Bima Yojana (RSBY). The NHPS is expected to provide major relief to families below poverty line. Linking of the beneficiaries with the Aadhaar based medical records can make sure that this scheme achieves its goals of benefiting most people without cost overruns. Hospitals that take care of the patient would be more accurately reimbursed in timely fashion, and with some modification in the terms of the scheme, some relief could be provided to the patients in their time of distress via Direct Benefit Transfer (DBT). Linking of beneficiaries within the NEMRS will ensure that there is no chance of fraud or errors.

NEMRS will simplify the process for making claims, since the details for the conditions for which the claims are made are already available, if the insurance verification system is integrated with the EMR. In effect, the claims processing could be reduced to a click on a button. Additionally, with the use of Blockchain based verification of healthcare events, a legitimate claim will never be denied, and a fraudulent one will never be approved.

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