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FICCI HEALTH
INSURANCE CONFERENCE
December 10, 2012 Recommendations
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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,
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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
FICCI Health Insurance Advisory
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
Mr. Girish Rao Co-Chairman & Chairman &
Managing Director
FICCI Health Insurance Advisory
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
Dr. Somil Nagpal Senior Health Specialist World Bank
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
Mr. Girish Rao Co-Chairman & Chairman &
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. Somil Nagpal Senior Health Specialist World Bank
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
23 | P a g e
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
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
24 | P a g e
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
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.
25 | P a g e
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
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
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
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
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
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
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
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
Max Bupa Health Insurance Co. Ltd.
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
Max Bupa Health Insurance Co. Ltd.
29 | P a g e
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
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.
30 | P a g e
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
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